Porto systemic shunt, also known as porto-systemic collateral circulation, refers to the abnormal connection between the portal vein and systemic circulation. This shunt allows blood to bypass the liver, leading to various complications. While porto systemic shunts can occur in the liver (A), anorectum (C), and gastroesophageal region (D), they are not typically seen in the spleen (B). The spleen does not have a direct connection to the portal vein and therefore does not contribute to porto systemic shunting.