|Drains from||Gastrointestinal tract, spleen, pancreas|
|Source||splenic vein, superior mesenteric vein, inferior mesenteric vein|
|Drains to||liver sinusoid|
|Latin||vena portae hepatis|
The portal vein or hepatic portal vein is a blood vessel that carries blood from the gastrointestinal tract, gallbladder, pancreas and spleen to the liver. This blood is rich in nutrients that have been extracted from food, and the liver processes these nutrients; it also filters toxins that may have been ingested with the food. 75% of total liver blood flow is through the portal vein, with the remainder coming from the hepatic artery proper. The blood leaves the liver to the heart in the hepatic veins.
The portal vein is not a true vein, because it conducts blood to capillary beds in the liver and not directly to the heart. It is a major component of the hepatic portal system, one of only two portal venous systems in the body – with the hypophyseal portal system being the other.
Conditions involving the portal vein cause considerable illness and death. An important example of such a condition is elevated blood pressure in the portal vein. This condition, called portal hypertension, is a major complication of cirrhosis.
In most individuals, the portal vein is formed by the union of the superior mesenteric vein and the splenic vein. For this reason, the portal vein is occasionally called the splenic-mesenteric confluence. Occasionally, the portal vein also directly communicates with the inferior mesenteric vein, although this is highly variable. Other tributaries of the portal vein include the cystic and gastric veins.
Immediately before reaching the liver, the portal vein divides into right and left. It ramifies further, forming smaller venous branches and ultimately portal venules. Each portal venule courses alongside a hepatic arteriole and the two vessels form the vascular components of the portal triad. These vessels ultimately empty into the hepatic sinusoids to supply blood to the liver.
The portal venous system has several anastomoses with the systemic venous system. In cases of portal hypertension these anastamoses may become engorged, dilated, or varicosed and subsequently rupture.
Accessory hepatic portal veins
Accessory hepatic portal veins are those veins that drain directly into the liver without joining the hepatic portal vein. These include the paraumbilical veins as well as veins of the lesser omentum, falciform ligament, and those draining the gallbladder wall.
Unlike most veins, the portal vein does not drain into the heart. Rather, it is part of a portal venous system that delivers venous blood into another capillary system, the hepatic sinusoids of the liver. In carrying venous blood from the gastrointestinal tract to the liver, the portal vein accomplishes two tasks: it supplies the liver with metabolic substrates and it ensures that substances ingested are first processed by the liver before reaching the systemic circulation. This accomplishes two things. First, possible toxins that may be ingested can be detoxified by the hepatocytes before they are released into the systemic circulation. Second, the liver is the first organ to absorb nutrients just taken in by the intestines. After draining into the liver sinusoids, blood from the liver is drained by the hepatic vein.
Increased blood pressure in the portal vein, called portal hypertension, is a major complication of liver disease, most commonly cirrhosis. Signs of portal hypertension include those of chronic liver disease: ascites, esophageal varices, spider nevi, caput medusae, and palmar erythema.
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- Henry Gray (1901). Anatomy, Descriptive and Surgical (16 ed.). Philadelphia: Lea Brothers. p. 619.
- Harold M Chung; Chung, Kyung Won (2008). Gross anatomy. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 208. ISBN 0-7817-7174-9.
- Plinio Rossi; L. Broglia (2000). Portal Hypertension: Diagnostic Imaging and Imaging-Guided Therapy. Berlin: Springer. p. 51. ISBN 3-540-65797-5.
- Benjamin L. Shneider; Sherman, Philip M. (2008). Pediatric Gastrointestinal Disease. Connecticut: PMPH-USA. p. 751. ISBN 1-55009-364-9.
- Dooley, James; Sherlock, Sheila (2002). Diseases of the liver and biliary system. Oxford: Blackwell Science. ISBN 0-632-05582-0.
- Key Topics in General Surgery (2 ed.). Informa Healthcare. 2002. ISBN 1-85996-164-9.
- Plemmons RM, Dooley DP, Longfield RN (November 1995). "Septic thrombophlebitis of the portal vein (pylephlebitis): diagnosis and management in the modern era". Clin. Infect. Dis. 21 (5): 1114–20. doi:10.1093/clinids/21.5.1114. PMID 8589130.
- Perez-Cruet MJ, Grable E, Drapkin MS, Jablons DM, Cano G (May 1993). "Pylephlebitis associated with diverticulitis". South. Med. J. 86 (5): 578–80. doi:10.1097/00007611-199305000-00020. PMID 8488411.
Section across portal triad of pig.
- Anatomy photo:38:12-0109 at the SUNY Downstate Medical Center - "Stomach, Spleen and Liver: The Visceral Surface of the Liver"
- Anatomy image:7959 at the SUNY Downstate Medical Center
- Anatomy image:8565 at the SUNY Downstate Medical Center
- Anatomy image:8697 at the SUNY Downstate Medical Center
- Cross section image: pembody/body8a - Plastination Laboratory at the Medical University of Vienna
- figures/chapter_30/30-2.HTM: Basic Human Anatomy at Dartmouth Medical School