Hepatic portal vein

The hepatic portal veinAnatomical features of the hepatic portal vein, its tributaries and outflow areas
~ 3 min

In this note, we will consider the anatomy, areas of blood drainage, and anastomoses of the hepatic portal vein.

The hepatic portal vein (v. portae hepatis) is the largest visceral vein and the main vessel of the portal system of the liver.

Hepatic portal vein (v. portae hepatis)
Hepatic portal vein (v. portae hepatis)

It is located in the thickness of the hepatoduodenal ligament.

It is formed from the veins of the unpaired abdominal organs: stomach, small and large intestines (except for the anal canal), spleen and pancreas. From these organs, venous blood flows through the portal vein to the liver, and from the liver through the hepatic veins to the inferior vena cava.

The portal vein is formed by the merge of the superior mesenteric vein with the splenic vein.The portal vein ends by the liver and divides into portal venules, which in turn end by the hepatic sinusoids. The sinusoids end by the central veins, the central veins end by the hepatic veins, and the hepatic veins end by the inferior vena cava.

Thus, the blood flowing into the inferior vena cava through the hepatic veins passes on its way through two capillary networks: the one located in the walls of the digestiv ract, where the tributaries of the portal vein arise, and another formed in the hepatic parenchyma from the capillaries of its lobules.

Venous capillaries liver (vv. jejunales et vv. ileales)
Venous capillaries liver

Tributaries of the vein are usually divided into main and accessory.

The main tributaries include two veins:

  1. The superior mesenteric vein (v. mesenterica superior);

    Superior mesenteric vein (v. mesenterica superior)
    Superior mesenteric vein (v. mesenterica superior)
  2. The splenic vein (v. lienalis).

Splenic vein (v. lienalis)
Splenic vein (v. lienalis)

Additional tributaries include 4 venous vessels:

  1. The posterior superior pancreaticoduodenal vein (v. pancreaticoduodenalis posterior superior);

    Posterior superior pancreaticoduodenal vein (v. pancreaticoduodenalis posterior superior)
    Posterior superior pancreaticoduodenal vein (v. pancreaticoduodenalis posterior superior)
  2. The left gastric vein (v. gastrica sinistra)

    Left gastric vein (v. gastrica sinistra)
    Left gastric vein (v. gastrica sinistra)
  3. The right gastric vein (v. gastrica dextra)

    Right gastric vein (v. gastrica dextra)
    Right gastric vein (v. gastrica dextra)
  4. The inferior mesenteric vein (v. mesenterica inferior)

Inferior mesenteric vein (v. mesenterica inferior)
Inferior mesenteric vein (v. mesenterica inferior)

Let’s consider the main tributaries.

The superior mesenteric vein (v. mesenterica superior) passes in the root of the mesentery of the small intestine to the right of the artery of the same name.

Superior mesenteric vein (v. mesenterica superior)
Superior mesenteric vein (v. mesenterica superior)
Superior mesenteric vein (v. mesenterica superior)
Superior mesenteric vein (v. mesenterica superior)

Its tributaries are:

  • Jejunal veins (vv. jejunales)

  • Ileal veins (vv. ileales);

    Jejunal veins (vv. jejunales et vv. ileales)
    Jejunal veins (vv. jejunales et vv. ileales)
    Jejunal veins and Ileal veins (vv. jejunales et vv. ileales)
    Jejunal veins and Ileal veins (vv. jejunales et vv. ileales)
  • Pancreatic veins (vv. pancreaticae);

  • Pancreaticoduodenal veins (vv. pancreaticoduodenales);

  • The ileocolic vein (v. ileocolica);

    Ileocolic vein (v. ileocolica)
    Ileocolic vein (v. ileocolica)
  • The right gastro-epiploic vein (v. gastroepiploica dextra);

    Right gastro-epiploic vein (v. gastroepiploica dextra)
    Right gastro-epiploic vein (v. gastroepiploica dextra)
  • The right colic vein (v. colica dextra)

    Right colic vein (v. colica dextra)
    Right colic vein (v. colica dextra)
  • The middle colon vein (v. colica media);

    Middle colon vein (v. colica media)
    Middle colon vein (v. colica media)
  • The appendicular vein (v. appendicularis).

    Appendicular vein (v. appendicularis)
    Appendicular vein (v. appendicularis)

    Through them, blood flows from the corresponding organ nto the superior mesenteric vein.

    The splenic vein (v. lienalis) passes along the superior border of the pancreas below the splenic artery from left to right, crossing the aorta in front. Behind the mead of the pancreas, the splenic vein merges with the superior mesenteric vein.

    Splenic vein (v. lienalis)
    Splenic vein (v. lienalis)
    Splenic vein (v. lienalis)
    Splenic vein (v. lienalis)

    Tributaries of the splenic vein are:

  • Pancreatic veins (vv. pancreaticae);

    Pancreatic veins (vv. pancreaticae)
    Pancreatic veins (vv. pancreaticae)
  • Short gastric veins (vv. gastricae breves)

    Short gastric veins (vv. gastricae breves)
    Short gastric veins (vv. gastricae breves)
  • The left gastro-epiploic vein (v. gastroepiploica sinistra).

    Left gastro-epiploic vein (v. gastroepiploica sinistra)
    Left gastro-epiploic vein (v. gastroepiploica sinistra)

    The latter anastomoses with the right vein of the same name along the greater curvature of the stomach. The splenic vein drains blood from the spleen, part of the stomach, pancreas and greater omentum.

    Let’s consider the additional tributaries of the portal vein.

    The left gastric vein (v. gastrica sinistra) is a short vein running along the superior half of the lesser curvature of the stomach. It arises in the middle of the lesser curvature of the stomach, passes posteriorly from the lesser omentum and ends by a confluence with the portal vein.

    Left gastric vein (v. gastrica sinistra)
    Left gastric vein (v. gastrica sinistra)

    The right gastric vein (v. gastrica dextra) is a short vein running along the inferior half of the lesser curvature of the stomach.

    Right gastric vein (v. gastrica dextra)
    Right gastric vein (v. gastrica dextra)

    It arises in the middle of the lesser curvature of the stomach, passes down the lesser curvature, and passes posteriorly from the lesser omentum, ending by a confluence with the portal vein.

    The posterior superior pancreatoduodenal vein (v. pancreaticoduodenalis posterior superior) drains blood from the mead of the pancreas. Most often it is a tributary of the superior mesenteric vein, but in some cases it can end directly by the portal vein.

    Posterior superior pancreatoduodenal vein (v. pancreaticoduodenalis posterior superior)
    Posterior superior pancreatoduodenal vein (v. pancreaticoduodenalis posterior superior)

    The inferior mesenteric vein (v. mesenterica inferior) is a variable tributary normally found in a small number of people.

    Inferior mesenteric vein (v. mesenterica inferior)
    Inferior mesenteric vein (v. mesenterica inferior)
    Inferior mesenteric vein (v. mesenterica inferior)
    Inferior mesenteric vein (v. mesenterica inferior)

    It is formed as a result of the confluence of several tributaries:

  • The superior rectal vein (v. rectalis superior)

    Superior rectal vein (v. rectalis superior)
    Superior rectal vein (v. rectalis superior)
  • The left colic vein (v. colica sinistra)

    Left colic vein (v. colica sinistra)
    Left colic vein (v. colica sinistra)
  • Sigmoid veins (vv. sigmoideae)

    Sigmoid veins (vv. sigmoideae)
    Sigmoid veins (vv. sigmoideae)

    The inferior mesenteric vein goes superiorly, located next to the left colic artery, passes behind the pancreas and end by the splenic vein (sometimes by the superior mesenteric vein). The inferior mesenteric vein drains blood from the walls of the superior part rectum, sigmoid colon and descending colon.

    In the thickness of the hepatoduodenal ligament, variable tributaries can also end by the portal vein:

  • The cystic vein (v. cystica)

    Cystic vein (v. cystica)
    Cystic vein (v. cystica)
  • The right gastric vein (v. gastrica dextra)

  • The left gastric vein (v. gastrica sinistra)

  • The prepiloric vein (v. prepylorica).

Prepiloric vein (v. prepylorica)
Prepiloric vein (v. prepylorica)
Dictionary

The hepatic portal vein

Hepatic portal vein
v. portae hepatis
Superior mesenteric vein
v. mesenterica superior
Veins of the jejunum andileum
vv. jejunales et ileales
Pancreatic veins
vv. pancreaticae
Pancreaticoduodenal veins
vv. pancreaticoduodenales
Ileocolic vein
v. ileocolica
Right gastro-omental vein
v. gastroepiploica dextra
Right and middle colic veins
vv. colicae media et dextra
Appendicular vein
v. appendicularis
Splenic vein
v. lienalis
Short gastric veins
vv. gastricae breves
Left gastro-epiploic vein
v. gastroepiploica sinistra
Left gastric vein
v. gastrica sinistra
Right gastric vein
v. gastrica dextra
Posterior superiorpancreaticoduodenal vein
v. pancreaticoduodenalis posterior superior
Inferior mesenteric vein
v. mesenterica inferior
Superior rectal vein
v. rectalis superior
Left colic vein
v. colica sinistra
Sigmoid veins
vv. sigmoideae
Cystic vein
v. cystica
Right and leftgastric veins
vv. gastricae dextra et sinistra
Prepiloric vein
v. prepylorica
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