The Inferior Mesenteric Artery - Position - Branches - TeachMeANatomy
Mar 8, around the superior mesenteric vein (SMV) and artery, is facing a . The anatomical relation between the ileocolic (ICA: A and B images) and. The splenic vein and superior mesenteric vein (SMV) join to form the main portal Its wall is thick, like an artery, and contains a high proportion of collagen and fat resulting from a connection between the portal venous system within the liver. Scanning is performed during the arterial and venous phases at 25 and 50 seconds lies posterior to the mesenteric vein, although this relationship is variable.
The splenic vein, after emerging from the hilum of the spleen, coursed upwards and to the right, embedded in a groove on the anterior surface of the body of the pancreas Figure 1. After a course of 5 cm, it suddenly turned downward and entered the body of the pancreas and coursed downward and to the right within the body of the pancreas Figure 2. It emerged out of the body of the pancreas just before its union with the superior mesenteric vein to form the portal vein.
Its union with the portal vein had a wide angle of about degrees Figure 3.
Superior mesenteric vein - Wikipedia
The splenic vein received its normal tributaries such as short gastric veins, left gastroepiploic vein and pancreatic veins. The left gastric vein drained directly into the portal vein. The splenic artery passed behind the upper border of the pancreas till the midpoint of pancreas and there upon it accompanied the splenic vein in the groove on the anterior surface of the pancreas.
Dissection of the upper abdomen showing variant relation of the splenic vein with the pancreas. Stomach has been reflected upwards. Splenic vein has been pulled out from its groove on the anterior surface of the body of the pancreas. Dissection of the upper abdomen showing downward course of the splenic vein before joining the superior mesenteric vein. Hence, when it shows variation, there are higher chances for its iatrogenic injuries. In the current case, the vein ran in a groove on the anterior surface of the pancreas along with the splenic artery for a significant distance.
Thereafter, it turned down and entered the pancreas.
After coming out from the substance of pancreas, it joined the superior mesenteric vein at an angle of degrees. This type of confluence might result in venous stagnation in either splenic vein or superior mesenteric vein because of the head on collision between the blood flowing in these two vessels. In the clinical perspective, this course might confuse the radiologists while interpreting the radiological findings.
Till date, there is no report of such a course and mode of termination of splenic vein.
[The relationship of the inferior mesenteric vein with arteries].
Knowledge of possible variations of splenic vein is very important to general surgeons, radiologists and gastroenterologists. In the surgical treatment for cancer of head of the pancreas, resection of the junction of splenic, superior mesenteric and portal veins is usually performed [ 6 ].
- The Inferior Mesenteric Artery
- Superior mesenteric vein
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A sound knowledge of splenic vein variation is required in this procedure. In the current case the confluence of these three veins was not of usual pattern. Intrapancreatic course of the terminal part of the splenic vein and its downward direction before termination might lead to confusions. In the traumatic avulsions of superior mesenteric vein, splenic vein turndown is performed.Superior Mesenteric Artery
It is a difficult procedure and one of the studies reports that only 4 out of 6 patients survived after this procedure [ 7 ]. Even in total pancreatico-duodenectomy, the confluence of splenic, superior mesenteric and portal vein has to be resected [ 8 ].
The current case may prove it to be very dangerous due to the varied course and termination of the splenic vein. One of the popular procedures in pancreatic surgery is laparoscopic splenic vessel preserving distal pancreatectomy.
Splenic vein thrombosis or stenosis is one of the post-operative complications of this procedure. In the current case that risk may be higher due to the variation in the course of the vein [ 9 ].
CT Anatomy of the Upper Abdomen
The knowledge of current variation is also important in portal vein reconstruction with splenic vein autograft [ 10 ]. Currently, the multidetector computed tomography MDCT is extensively being used to know the variations in the course of the blood vessels and to know the extent of the tumour [ 11 ].
This technology may be very useful in knowing the variant course of the splenic vein in the current case. In the current case, the unusual course of the splenic vein makes it vulnerable in pancreatitis and pancreatic surgeries. They radiate in a wheel-like fashion. Increased fluid in the peritoneal cavity. Can result from the liver's inability to handle increased blood pressure.
Varicose veins in the anal regions.
Blood backflow into eosphageal plexus could make you cough up or vomit blood from portal hypertension. Important clinical diagnostic sign. In the event of portal hypertension or portal stenosis. The paraumbilical vein feeds into the portal vein, in the left lobe the liver.
These are usually closed off after birth, but in the event of portal hypertension, they can recanalize. Blood back flows into the left gastric and eventually makes its way back to the azygos vein. At the pectinate line is another collateral pathway. The two venous systems anastomose with each other, so backflow can take the alternative route at that location.
Hemorrhoids in the upper anal canal caused by varicosities of the superior rectal vein. They are innervated by autonomic nerves and hence are not painful. Varicosities of the inferior and middle rectal veins.