blood supply and venous drainage of the gastro-intestinal tract and liver
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Blood supply and venous drainage of the gastro-intestinal
tract and liver
Raymond G BuickPaediatric Surgeon
Birmingham UK
alimentary tract
alimentary tract
alimentary tract
Gastro-intestinal tract
Gastro-intestinal tract
Gastro-intestinal tract
Oesophago-gastric junction
Gastro-intestinal tract
Oesophago-gastric junction
anus
Gastro-intestinal tract
Approximate length of the adult gut
• The SMALL intestine = 7m long
• The LARGE intestine = 1.5 m long
• Stomach = 0.5 m
• TOTAL = 9 m
Arterial Supply to GI Tract
upper and lower GI tracts
upper and lower GI tracts
Embryological – 1 23
upper and lower GI tracts
Embryological – 1 23
FOREHEAD
BEHIND
upper and lower GI tracts
Embryological – 1 foregut 2 3
FOREHEAD
BEHIND
FOREGUT
upper and lower GI tracts
Embryological – 1 foregut 2 3 hindgut
FOREHEAD
BEHIND
HINDGUT
FOREGUT
upper and lower GI tracts
Embryological – 1 foregut 2 midgut3 hindgut
MIDGUT
HINDGUT
FOREGUT
upper and lower GI tracts
Embryological – foregut midguthindgut
HINDGUT
FOREGUT
MIDGUT
FOREGUT
HINDGUT
• coeliac artery
• superior mesenteric artery
• inferior mesenteric artery
• coeliac artery
• superior mesenteric artery
• inferior mesenteric artery
MIDGUT
FOREGUT
HINDGUT
watershedwatershed
Coeliac Artery
left gastric artery– oesophageal branch– hepatic branch
hepatic artery– right gastric artery– gastro-duodenal artery
» right gastro-epiploic artery» superior pancreatico-duodenal artery
splenic artery– left gastro-epiploic artery– short gastric arteries– pancreatic branches
Coeliac Artery
left gastric arteryoesophageal branchhepatic branch
hepatic artery– right gastric artery– gastro-duodenal artery
» right gastro-epiploic artery» superior pancreatico-duodenal artery
splenic artery– left gastro-epiploic artery– short gastric arteries– pancreatic branches
Coeliac Artery
left gastric artery– oesophageal branch– hepatic branch
hepatic artery right gastric artery gastro-duodenal artery right gastro-epiploic artery superior pancreatico-duodenal arterysplenic artery
– left gastro-epiploic artery– short gastric arteries– pancreatic branches
Coeliac Artery
left gastric artery– oesophageal branch– hepatic branch
hepatic artery right gastric artery gastro-duodenal artery right gastro-epiploic artery superior pancreatico-duodenal arterysplenic artery
– left gastro-epiploic artery– short gastric arteries– pancreatic branches
Coeliac Artery
left gastric artery– oesophageal branch– hepatic branch
hepatic artery– right gastric artery– gastro-duodenal artery
» right gastro-epiploic artery» superior pancreatico-duodenal artery
splenic arteryshort gastric arteriesleft gastro-epiploic arterypancreatic branches
Coeliac Artery
left gastric artery– oesophageal branch– hepatic branch
hepatic artery– right gastric artery– gastro-duodenal artery
» right gastro-epiploic artery» superior pancreatico-duodenal artery
splenic arteryshort gastric arteriesleft gastro-epiploic arterypancreatic branches
Coeliac Artery
left gastric artery– oesophageal branch– hepatic branch
hepatic artery– right gastric artery– gastro-duodenal artery
» right gastro-epiploic artery» superior pancreatico-duodenal artery
splenic arteryshort gastric arteriesleft gastro-epiploic arterypancreatic branches
Coeliac Artery
left gastric artery– oesophageal branch– hepatic branch
hepatic artery– right gastric artery– gastro-duodenal artery
» right gastro-epiploic artery» superior pancreatico-duodenal artery
splenic artery– left gastro-epiploic artery– short gastric arteries– pancreatic branches
Coeliac Artery
left gastric artery– oesophageal branch– hepatic branch
hepatic artery– right gastric artery– gastro-duodenal artery
» right gastro-epiploic artery» superior pancreatico-duodenal artery
splenic artery– left gastro-epiploic artery– short gastric arteries– pancreatic branches
• coeliac artery
• superior mesenteric artery
• inferior mesenteric artery
• coeliac artery
• superior mesenteric artery
• inferior mesenteric artery
watershed
Venous drainage of GI Tract
Venous drainage of GI Tract• Veins follow (+/-) arteries
• inferior mesenteric vein drains to splenic vein
• splenic vein joins superior mesenteric vein to form the portal vein
Venous drainage of GI Tract• Veins follow (+/-) arteries
• inferior mesenteric vein drains to splenic vein
• splenic vein joins superior mesenteric vein to form the portal vein
Venous drainage of GI Tract• Veins follow (+/-) arteries
• inferior mesenteric vein drains to splenic vein
• splenic vein joins superior mesenteric vein to form the portal vein
Venous drainage of GI Tract• Veins follow (+/-) arteries
• inferior mesenteric vein drains to splenic vein
• splenic vein joins superior mesenteric vein to form the portal vein
Venous drainage of GI Tract• Veins follow (+/-) arteries
• inferior mesenteric vein drains to splenic vein
• splenic vein joins superior mesenteric vein to form the portal vein
Venous drainage of GI Tract• Veins follow (+/-) arteries
• inferior mesenteric vein drains to splenic vein
• splenic vein joins superior mesenteric vein to form the portal vein
Venous drainage of GI Tract• Veins follow (+/-) arteries
• inferior mesenteric vein drains to splenic vein
• splenic vein joins superior mesenteric vein to form the portal vein
Venous drainage of GI Tract• Veins follow (+/-) arteries
• inferior mesenteric vein drains to splenic vein
• splenic vein joins superior mesenteric vein to form the portal vein
porta hepatis
Venous drainage of GI Tract
Hepatic veins
Hepatic artery
Portal vein
IVC
.
.
Venous drainage of GI Tract
• Nutritents and substances absorbed from the GI tract
• Disease spread (eg tumour spread) from the GI tract to liver
• Portal hypertension – varicies
Venous drainage of GI Tract
Capillary circulation in the liver
Oesophageal veins draining into left gastric vein
Connection between superior rectal vein (portal) and middle rectal vein (systemic)
Venous drainage of GI Tract
Oesophageal veins draining into left gastric vein
Connection between superior rectal vein (portal) and middle rectal vein (systemic)
OESOPHAGEAL VARICIES
HAEMORRHOIDS
The End
• Why don’t you take some exam questions on this topic from our MCQ’s section
CREDITShttp://www.google.co.uk/imgres?imgurl=http://www.nlm.nih.gov/medlineplus/ency/images/ency/fullsize/8940.jpg&imgrefurl=http://www.nlm.nih.gov/medlineplus/ency/imagepages/8940.htm&usg=__1a3e1phdRRV9XLGpjzi0Iu88sBE=&h=320&w=400&sz=14&hl=en&start=0&zoom=1&tbnid=bXTOSvTwIbx3cM:&tbnh=128&tbnw=160&ei=TBXlTbHcDMur-gaRoIC5Dw&prev=/search%3Fq%3Dintestines%26um%3D1%26hl%3Den%26sa%3DN%26rlz%3D1W1SNYK_en-GB%26biw%3D1175%26bih%3D554%26tbm%3Disch&um=1&itbs=1&iact=hc&vpx=898&vpy=51&dur=2730&hovh=201&hovw=251&tx=139&ty=126&page=1&ndsp=18&ved=1t:429,r:11,s:0&biw=1175&bih=554
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