blood supply and venous drainage of the gastro-intestinal tract and liver
TRANSCRIPT
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Blood supply and venous drainage of the gastro-intestinal
tract and liver
Raymond G BuickPaediatric Surgeon
Birmingham UK
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alimentary tract
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alimentary tract
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alimentary tract
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Gastro-intestinal tract
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Gastro-intestinal tract
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Gastro-intestinal tract
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Oesophago-gastric junction
Gastro-intestinal tract
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Oesophago-gastric junction
anus
Gastro-intestinal tract
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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
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Arterial Supply to GI Tract
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upper and lower GI tracts
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upper and lower GI tracts
Embryological – 1 23
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upper and lower GI tracts
Embryological – 1 23
FOREHEAD
BEHIND
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upper and lower GI tracts
Embryological – 1 foregut 2 3
FOREHEAD
BEHIND
FOREGUT
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upper and lower GI tracts
Embryological – 1 foregut 2 3 hindgut
FOREHEAD
BEHIND
HINDGUT
FOREGUT
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upper and lower GI tracts
Embryological – 1 foregut 2 midgut3 hindgut
MIDGUT
HINDGUT
FOREGUT
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upper and lower GI tracts
Embryological – foregut midguthindgut
HINDGUT
FOREGUT
MIDGUT
FOREGUT
HINDGUT
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• coeliac artery
• superior mesenteric artery
• inferior mesenteric artery
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• coeliac artery
• superior mesenteric artery
• inferior mesenteric artery
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MIDGUT
FOREGUT
HINDGUT
watershedwatershed
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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
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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
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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
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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
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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
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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
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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
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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
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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
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• coeliac artery
• superior mesenteric artery
• inferior mesenteric artery
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• coeliac artery
• superior mesenteric artery
• inferior mesenteric artery
watershed
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Venous drainage of GI Tract
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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
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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
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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
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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
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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
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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
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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
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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
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Venous drainage of GI Tract
Hepatic veins
Hepatic artery
Portal vein
IVC
.
.
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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
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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)
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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
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The End
• Why don’t you take some exam questions on this topic from our MCQ’s section
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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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• http://www.google.co.uk/imgres?imgurl=http://home.comcast.net/~wnor/portalsystem.jpg&imgrefurl=http://home.comcast.net/~wnor/largeintestine.htm&usg=__7W7HYAx4Y5NGcxJd8TKKmXEcnkI=&h=622&w=450&sz=37&hl=en&start=0&zoom=1&tbnid=HheSUTpAx5xwmM:&tbnh=129&tbnw=93&ei=nFHmTaHlKJGBswa5mPyCCA&prev=/search%3Fq%3Dvenous%2Bdrainage%2Bof%2BG%2BI%2BTract%26um%3D1%26hl%3Den%26sa%3DG%26rlz%3D1R2SNYK_en-GB%26biw%3D1175%26bih%3D554%26tbm%3Disch&um=1&itbs=1&iact=rc&dur=468&page=1&ndsp=23&ved=1t:429,r:0,s:0&tx=72&ty=70
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• http://www.google.co.uk/imgres?imgurl=http://i.quizlet.net/i/Eu8j13aAFISQDyL5ktkHGg_m.jpg&imgrefurl=http://quizlet.com/3464340/gastrointestinal-anatomy-5-liver-flash-cards/&usg=__KP8uTVRGeuuzyhDPRuULdAoPJKU=&h=240&w=212&sz=18&hl=en&start=41&zoom=1&tbnid=6Q6dbZRzvFpdSM:&tbnh=120&tbnw=106&ei=V5nnTdj3JIaEhQfx2bnFCg&prev=/search%3Fq%3Dporta%2Bhepatis%2Banatomy%26um%3D1%26hl%3Den%26sa%3DN%26rlz%3D1R2SNYK_en-GB%26biw%3D1175%26bih%3D554%26tbm%3Disch&um=1&itbs=1&iact=hc&vpx=135&vpy=228&dur=158&hovh=192&hovw=169&tx=106&ty=170&page=3&ndsp=19&ved=1t:429,r:12,s:41&biw=1175&bih=554
• http://www.google.co.uk/imgres?imgurl=http://www.projo.com/extra/2003/medical_pioneers/images/20040411_liver.jpg&imgrefurl=http://www.projo.com/news/content/projo_20040411_vacanti11.23dab9.html&usg=__ZhZJVQ7kifEwwwX_0oJTvv4duPk=&h=300&w=320&sz=13&hl=en&start=0&zoom=1&tbnid=WQM2FZUcztw11M:&tbnh=127&tbnw=135&ei=SNvoTZPeF8ay8gOIzYiXAQ&prev=/search%3Fq%3Dcirculation%2Bin%2Bthe%2Bliver%26hl%3Den%26sa%3DG%26biw%3D1175%26bih%3D554%26gbv%3D2%26tbm%3Disch&itbs=1&iact=rc&dur=452&page=1&ndsp=18&ved=1t:429,r:6,s:0&tx=80&ty=67
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