The document summarizes the blood supply of the gastrointestinal tract in three parts: 1) The arterial supply comes from branches off the abdominal aorta including the celiac trunk, superior mesenteric artery, and inferior mesenteric artery. 2) Venous drainage occurs through the portal vein, which is formed by the superior mesenteric vein and splenic vein. It drains into the liver. 3) The hepatic portion describes the hepatic arteries, portal vein branches in the liver, hepatic lobules, and hepatic veins draining into the inferior vena cava.

1. Blood Supply of GIT
Dr. Komal Parmar
Total Number of Slides: 45

2. Aims and Objectives
• Understanding the three dimensional topography of vascular
system inside the abdominopelvic cavity.
• Detailed description of the blood supply of gastrointestinal
tract.
• Clinical and pathological correlation.
2

3. Blood Supply of Oropharynx
3

4. Blood Supply of Oesophagus
4

5. Entry into the Abdominal Cavity
• T8: Caval Opening
• IVC
• Right Phrenic Nerve
• T10: Esophageal Hiatus
• Esophagus
• Vagal Trunks
• Esophageal Vessels
• T12: Aortic Hiatus
• Aorta
• Thoracic Duct
• Azygous Vein 5
Thoracoabdominal
Interface

6. 6

7. General Arrangement of
Abdominopelvic Vascular Supply:
Arterial Supply
7

8. Venous System
8

9. 9
Portal Venous System

10. Arterial
Supply
10

11. Abdominal Aorta
• Begins at Aortic hiatus of
Diaphragm: T12
• Bifurcates into two common iliac
arteries at L4/5 intervertebral disc.
• Mean diameter=
• 19-21mm in males
• 16-18mm in females
• Relations:
• Anterior= Coeliac trunk, Autonomic nerve
plexuses, lymphatics, pancreas, 3rd part of
duodenum, root of mesentry
• Posterior: Vertebrae, I/V disc and
ligaments, Lumbar Arteries
• Right: Thoracic Duct, Azygous Vein, Right
Crus of Diaphragm, IVC, Right Coeliac
Ganglion.
• Left: Left Crus of Diaphragm, Left Coeliac
Ganglion, 4th part of Duodenum, Left
Sympathetic Trunk, Inferior mesenteric
Vein. 11

12. 12

13. Branches of Abdominal Aorta
• Anterior group
(unpaired)
• Coeliac Trunk
• Superior Mesenteric A
• Inferior Mesenteric A
• Lateral Group
• Middle Suprarenal A
• Renal A (R>L)
• Gonadal A
• Dorsal Group
• Inferior Phrenic A
• Lumbar A (4) (*** Artery of
Adamkewicz)
• Median Sacral A (1) 13

14. Coeliac Trunk
• T12
• 1-3 cm long.
• Trifucration and ramification
• Related to respective crus of diaphragm and coeliac ganglion on
each side.
14

15. 15

16. Splenic Artery
• Tortous. 8-32cm long.
• Largest branch of the coeliac trunk.
• Runs along the upper border of
pancreas.
• Branches
• Pancreatic
• Short Gastric
• Left Gastroepiploic
16

17. Common Hepatic Artery
17

18. 18

19. Superior Mesenteric Artery
• Originates 1 cm below
the Coeliac trunk
• Lower border of L1,
Transpyloric plane.
• Posterior relations:
uncinate process of
Pancreas, 3rd part of
Duodenum, left renal vein,
IVC, right ureter, right psoas.
• Anterior Relations:
Splenic vein and Body of
Pancreas.
• ***Marginal Artery
19

20. 20

21. Inferior Mesenteric Artery
• Arises behind the inferior border of 3rd part of Duodenum.
• 3-4 cm above the aortic bifurcation
21

22. 22

23. Rectal Arteries
23

24. 24

25. 25

26. 26
Veins

27. Mesenteric Veins
Inferior Mesenteric
• Begins as Superior
Rectal Vein.
• Receives
• Sigmoidal Veins and
• Left Colic Veins
• Drains into Splenic Vein
eventually.
Superior Mesenteric
• Tributaries
• Right Gastroepiploic V
• Inferior
Pancreaticoduodenal V
• Middle colic V
• Right Colic V
• Ileocolic V
• Ileal V
• Jejunal V
• Drains into: Portal Vein
27

28. 28

29. Splenic Vein
• Tributaries
• Short Gastric
• Left Gastroepiploic
• Pancreatic Veins
• Inferior Mesenteric
29

30. Portal Venous Circulation
30

31. Portal Vein
• Formed behind the neck of Pancreas at the level of L1/2
intervertebral disc.
• Superior mesenteric Vein + Splenic vein
• 8cm
• Ascends behind the 1st part of Duodenum, CBD and
gastroduodenal artery.
• Enters the right border of Lesser Omentum and reaches the
right end of Porta hepatis behind CBD and Hepatic Artery.
• Divides into R and L branches which accompany the
corresponding Hepatic Artery.
• Tributaries: Left gastric and Posterior Superior
Pancreaticoduodenal. Cystic veins, Para Umbilical veins. 31

32. 32

33. 33

34. 34
Hepatic
Lobule

35. Hepatic Veins
• The hepatic veins are divided
into upper and lower groups
• The upper three drain the
central veins from the right,
middle, and left regions of the
liver and are larger than the
lower group of veins.
• The lower group of from six to
twenty smaller hepatic veins
come from the right lobe and
the caudate lobe, are in contact
with the hepatic tissue, and are
valveless. All the veins empty
into the inferior vena cava at
the back of the liver. 35
Hepatic veins
draining into IVC

36. Inferior Vena Cava
36

37. IVC
• Formed by the junction of the common iliac veins anterior to
the 5th lumbar vertebral body.
• Tributaries
• Lumbar veins
• Right Gonadal vein
• Renal veins (L>R)
• Right Suprarenal vein
• Inferior phrenic veins
• Hepatic Veins
37

38. 38

39. • Portosystemic Shunt:
Occur at the sites of Porto-
Caval Anastamoses
39
Clinical Correlates

40. Aortic Aneurysm
40

41. Gastrointertinal Bleeding
41

42. Mesenteric Ishchemia
42

43. Intestinal
Resection and
Anastomoses
43

44. Conclusions
• Arterial system and Venous system do not follow an exactly
parallel system.
• Importance of Portal Venous system and Liver as the focal site
of metabolism.
• Correlation of anatomical intricacies with the Clinical
requirements.
• Tip for consolidating the information: Look at the figures and
approach it conceptually.
44

45. 45