Venous Drainage of GI
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1
The portal vein is formed behind the by the union of the and the
The portal vein is formed behind the head of the
pancreas by the union of the SMV and the splenic
vein
pancreas by the union of the SMV and the splenic
vein
2
Veins that brach out from portal system
1. Portal vein
2. IMV
3. SMV
4. Splenic vein
2. IMV
3. SMV
4. Splenic vein
3
**TEST QUESTION Esophageal veins go to azygous but goes to portal system
**TEST QUESTION Esophageal veins go to azygous but EVERYTHING ELSE goes to portal system
4
Schematic for blood supply
5
Tributaries of splenic vein
• Short gastric veins
• Left gastroepiploic vein
• Pancreatic vein (Dorsal pancreatic vein, Great pancreatic vein, Caudal pancreatic vein)
• IMV begins in the rectum as the superior rectal vein (Sigmoid veins and Left colic vein)
• Left gastroepiploic vein
• Pancreatic vein (Dorsal pancreatic vein, Great pancreatic vein, Caudal pancreatic vein)
• IMV begins in the rectum as the superior rectal vein (Sigmoid veins and Left colic vein)
6
Tributaries of the SMV
• Ileal and jejunal veins
• Ileocolic vein
• Right colic vein
• Middle colic vein
• Right gastroepiploic vein
• Pacreaticoduodenal vein
• Ileocolic vein
• Right colic vein
• Middle colic vein
• Right gastroepiploic vein
• Pacreaticoduodenal vein
7
runs along the
lesser curvature of the
stomach
lesser curvature of the
stomach
PYLORIC VEIN runs along the
lesser curvature of the
stomach
lesser curvature of the
stomach
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drains the
gallbladder and accompanies
the cystic duct
gallbladder and accompanies
the cystic duct
CYSTIC VEIN drains the
gallbladder and accompanies
the cystic duct
gallbladder and accompanies
the cystic duct
9
Esophageal veins via the
anastomose with
anastomose with
Esophageal veins via the azygos vein (systemic)
anastomose with left gastric vein (portal vein)
anastomose with left gastric vein (portal vein)
10
Portal system takes blood to the to be processed and then take to
Portal system takes blood to the liver to be processed and then take to IVC.
11
The systemic approach to venous drainage to the ( )
The systemic approach to venous drainage to the azygous (esophageal veins)
12
There are 5 main tributaries of the portal vein
1.
2.
3.
4.
5.
1.
2.
3.
4.
5.
There are 5 main tributaries of the portal vein
1. Splenic
2. SMV
3. Pyloric vein
4. Cystic vein
5. Paraumbilical
1. Splenic
2. SMV
3. Pyloric vein
4. Cystic vein
5. Paraumbilical
13
Portal vein is combo of and
Portal vein is combo of SMV and splenic
14
Superior rectal is different that esophageal and paraunbilical because it drains to the first
Superior rectal is different that esophageal and paraunbilical because it drains to the PORTAL VEIN first
15
1.Esophageal ( ) =
Left gastric ( )
Left gastric ( )
1.Esophageal (azygos) =
Left gastric (portal)
Left gastric (portal)
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2. Superior rectal ( ) =
Inferior rectal ( )
Inferior rectal ( )
2. Superior rectal (portal) =
Inferior rectal (internal iliac)
Inferior rectal (internal iliac)
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3. Paraumbilical ( ) =
Superficial epigastric
( )
Superficial epigastric
( )
3. Paraumbilical (portal) =
Superficial epigastric
(great saphenous/femoral veins)
Superficial epigastric
(great saphenous/femoral veins)
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4-Colon ( ) =
Renal ( )
Renal ( )
4-Colon (portal) =
Renal (systemic)
Renal (systemic)
19
Portal is increased portal pressure that is caused by intrinsic liver disease of obstruction, or heaptic outflow
Portal hypertenson is increased portal pressure that is caused by intrinsic liver disease of obstruction, or heaptic outflow
20
Sympathetic Chain is
Sympathetic Chain is T1-L2
21
Autonomic parasympathetic plexus is by
Autonomic parasympathetic plexus is by vagus
22
– lifethreatening
Esophageal varices – lifethreatening
23
Superior rectal =
Inferior rectal and middle rectal and internal iliac =
Inferior rectal and middle rectal and internal iliac =
Superior rectal = portal
Inferior rectal and middle rectal and internal iliac = systemic
Inferior rectal and middle rectal and internal iliac = systemic
24
Renal/lumbar/phrenic ( ) = pancreas/liver/colon ( )
Renal/lumbar/phrenic (systemic) = pancreas/liver/colon (portal)