anatomy

1. PORTAL Vein

3. 0F glJT
Superior vena cava
Azygos vein -
Liver —
Diaphragm
Portal vein -----
Paraumbilical vein —
Umbilicus — —
Veins of anterior
abdominal wall
Rectum and anal canal

4. Hemiazygos vein
I^eft gastric vein
-Splenic vein
Inferior
-- Inferior
Superior
vena cava
mesenteric
mesenteric
vein
vein
__ Superior rectal vein
Middle rectal vein
— Inferior rectal vein
Lower end of oesophagus

5. common
blfe
duct
ligamentum
venosum
left
lobe
groove
for
inferior
lig amentum
teres
porta
hepatts
hepatic
artery porta]

6. 75%

7. r i
Portal Vein
Nutrient rich
Oxygen poor
Spleen
Pancreas
Intestines

9. Hepatic Artery
Oxygen rich
Nutrient poor

10. Descen
ding
colon
Ascend
ing
colon
Liver
► Righi gastric vem
gastric vein*
Stomach
Short
gastric vem tributaries
of splenic vein
Lefi go
siro
epiploic vein
Gallbladder
Posterior superior pancreafico
duodenal vein
Anterior superior pancrealico
duodenal voin
Midd Ic col ie vein*'--
Right gastroepiploic vein
Right colic vein
. Inferior Mesenteric vein*
First jejunal trunk
Inferior pancreaticoduodenal
vein
Branches
of Porlal
Gyslie vein

11. Relations
Infra duodenal
- Ant: Neck of Pancreas
- Post: IVC
Retro duodenal
- Ant: Duodenum (1st Part}, Bile duct, GD artery
- Post: IVC
Supra duodena! : In rtfree margin of Jesser omentum
- Ant: hepatic artery & bile duct
- Post: IVC
Surrounded by Hepatic plexus of nerves, lymphatics & LN

12. Portal vein
> Portal Canal > Hepatic sinusoids
v
Sublobar veins - Central veins
v
Hepatic veins
IVC

13. Slide
Connective
(Glisson's

15. Tributaries
Formative
- Sup Mesenteric vein “
Splenic vein
Received by Trunk
- Rt & It Gastric veins
- Superior PD vein
Received by branches
- Cystic vein
- Paraumbilical veins
Occasional
“ Inf mesenteric
- Rt gastro epiploic
- Pre-pyloric vein.
rijv jari>-: >+4-1

16. PORTO-CAYAL
ANASTOMOSIS

17. Normal circulation
*
Heart
■ Arteries
• Arterioles
(* Capillaries
• Venules •
Veins
Heart

18. Hepatic Portal System
• Heart
* After es
. r
r
» Capillary #1 (lamina propria)
* Venules
* Veins (Hepatic portal system of veins) *
*
• Veins
Venules
f-”-
I • Capillary #2 (hepatic sinusoids)
Venules
• Heart

19. Heoatic Portal Circulation
Arterial Venous
blood blood
Inferior—
vena cava
Stomach and intestine Uver
Liver cells (hepatocytes)
Nutrients and
toxins absorbed
Nutrients
and toxins
leave
Hepatic
portal
vein
First capillary bed Second capillary bed * (liver
sinusoids) HepaticT
-1 vein I
Hepatic portal system
Figure 11.16

20. Hepatic portal system

21. Hepatic portal system
Liver

22. Hepatic portal system
Esophagus

24. Hepatic portal system
Stomach

26. Hepatic portal system
Spleen

28. Hepatic portal system
Jejunum and Ileum

30. Hepatic portal system
Ascending colon

32. Hepatic portal system
Hindgut

34. Hepatic portal system
Hepatic portal vein

37. Hepatic portal system
Portal vein

40. Porto-Caval Anastomoses
1. Esophagus
Portal. Left gastric vein ■
HPV Caval Esophageal w. -
Azygos w.

42. Porto-Caval Anastomoses
]
3. Ant abdominal wall (portal drainage)
Periumbilical
veins Hepatic
portal vein

43. Porto-Caval Anastomoses
3. Ant abdominal wall (caval
drainage)
Superficial epigastric veins
Femoral vein External iliac
vein Common iliac vein IVC

46. Porto-Caval Anastomoses
2. Rectum (portal
drainage)
Superior rectal
vein Inf
mesenteric vein
Splenic vein HPV

47. Porto-Caval Anastomoses
2. Rectum (caval drainage)
Middle and inferior
rectal veins Internal
iliac vein Common iliac
vein

48. With hemorrhoids

50. Intemat Hemorrhoid

55. Eck's Fistula operation
(TIPS) Transjugular Intrahepatic
Porto-systemic Shunt