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Gastroenterology


Answer 1
  1. Splenic vein thrombosis. The patient has splenic vein thrombosis, most commonly caused by chronic pancreatitis. Splenic vein thrombosis leads to the formation of gastric varices, which can bleed profusely. Chronic pancreatitis explains the patient’s ill appearance and malnutrition. Hepatic vein thrombosis (Budd-Chiari syndrome) would present as hepatomegaly with ascites. SMV thrombosis does not lead to gastric varices and would be associated with diffuse pain. Pulmonary hypertension would produce hepatic congestion/hepatomegaly but not gastric varices. A splenic artery aneurysm would not lead to gastric varices.

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