anatomy of hepatic portal vein

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2. How did…
…Devdas die?

3. Portal system
Usual circulation Portal circulation

4. Hepatic Portal Vein
• Origin & end in capillaries / venous
sinusoids
• Size: 8cm X 1 cm
• Drains
– Abdominal part of alimentary
tract (except lower part of anal
canal)
– Spleen & Pancreas
• Conveys absorbed products of
digested food to liver
• Devoid of valves
• Reservoir of blood : 1200 ml / min

5. Formation
– Union of Sup mesenteric & Splenic vein
– Between neck of Pancreas & IVC at level L2

6. Course: Extrahepatic part
• Passes upwards & Rt,
behind neck of pancreas &
1st part of duodenum
• Enters rt free margin of
lesser omentum in front of
epiploic foramen with BD &
HA
• Reaches porta hepatis &
divides into rt & Lt
branches.

7. – Branches of portal vein
– Segmental brs
– Brs in Portal canal
– Hepatic sinusoids
– Central veins
– Sublobular veins
– Hepatic veins
IVC
Course: Intrahepatic part

8. Tributaries

9. Tributaries
• Formative
– Sup Mesenteric vein
– Splenic vein
• Received by Trunk
– Rt & lt Gastric veins
– Superior PD vein
• Received by branches
– Cystic vein
– Paraumbilical veins
• Occasional
– Inf mesenteric
– Rt gastro-epiploic
– Pre-pyloric vein.

10. Variations

12. Splenic vein & inferior
mesenteric vein open
independently into
superior mesenteric vein

13. Inferior mesenteric vein
Opens into superior
mesenteric vein

14. Branches
Rt Branch
 Shorter, wider
 Receives cystic vein
Lt branch
 Narrower, longer
 Runs in Porta hepatis
from Rt to Lt
 Brs to Caudate & Quadrate
lobe
 Receives Paraumbilical veins

15. Parts
3
1
2
• Infraduodenal
• Retroduodenal
• Supraduodenal

16. Relations
• Infra duodenal
– Ant: Neck of Pancreas
– Post: IVC
• Retro duodenal
– Ant: Duodenum (1st Part), Bile duct, GD artery
– Post: IVC
• Supra duodenal : In rt free margin of lesser omentum
– Ant : hepatic artery & bile duct
– Post: IVC
• Surrounded by Hepatic plexus of nerves, lymphatics & LN

17. Relations

18. Portocaval anastomosis

19. Site Caval Portal Effect in PHT
Lower end of
esophagus
Esophageal
tributaries of
hemiazygos V
Oesophageal
tributaries of Lt
gastric V
Oesophageal
varices
Umbilicus Veins of AAW Paraumbilical
veins
(tributaries of
Lt br of Portal V)
Caput medusae
Lower end of
rectum & Anal
canal
Middle & inf
rectal Vs
Sup rectal V Anorectal
varices, Internal
hemorrhoids

20. Site Caval Portal
Post abd wall • Lt renal V
• Veins of Post Abd
wall
• Splenic V
• Veins of
retroperitoneal
organs like
duodenum, Asc &
Desc colon
Bare area of liver Diaphragmatic veins Hepatic brs of Portal V
Liver Patent Ductus
venosus (rare)
Lt br of portal v
Post wall of vagina Vaginal venous plx Sup rectal v
Falciform lig Diaphragmatic v Paraumblical v

21. • > 12 mm of Hg
• Causes :
– Pre hepatic : Thrombosis of portal vein
– Hepatic: Cirrhosis
– Post hepatic: Budd-Chiari Syndrome
• Effects: Splenomegaly, Ascites, Collateral
circulation through sites of Portasystemic
anastomosis
Portal hypertension

22. Internal piles (Hemorrhoids)

23. Caput Medusae

24. Esophageal varices