Portal Vein : Tributaries and Portocaval Anastomoses

Origin: Hepatic Portal Vein is formed by the union of Splenic vein and Superior mesenteric Vein behind the neck of pancreas at L1 vertebral level.

Termination: The portal vein terminates by branching into right branch (entering right lobe of liver) and left branch entering (left lobe of liver).

portal vein schematic

Parts:

  1. Supraduodenal
  2. Retroduodenal
  3. Infraduodenal

Tributaries:

  1. Splenic vein
  2. Superior mesenteric vein
  3. Cystic vein
  4. Paraumbilical vein
  5. Right and Left gastric vein
  6. Superior pancreaticoduodenal vein

Points to remember:

Tributaries of splenic vein:

  • Veins corresponding to the branches of splenic artery
  • Inferior mesenteric vein

Tributaries of inferior mesenteric vein:

  • Veins corresponding to the branches of inferior mesenteric artery

Tributaries of superior mesenteric vein:

  • Veins corresponding to the branches of superior mesenteric artery
  • Inferior pancreaticoduodenal vein
  • Right gastroepiploic vein

Sites of Portocaval Anastomoses

SitePortal veinSystemic veinPortal hypertension
Abdominal esophagusEsophageal tributaries of left gastric vein Esophageal tributaries of accessory hemiazygos veinEsophageal varices
UmbilicusParaumbilical veinSuperficial epigastric veinCaput medusae
Anal canalSuperior rectal veinMiddle and Inferior rectal veinHemorrhoids
Bare area of liverHepatic venulesPhrenic and intercostal veins
Posterior abdominal wallTwigs of colic veinRetroperitoneal vein


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