Henry Gray (18251861). Anatomy of the Human Body. 1918.
conveyed to the inferior vena cava by the hepatic veins. From this it will be seen that the blood of the portal system passes through two sets of minute vessels, viz., (a) the capillaries of the digestive tube, spleen, pancreas, and gall-bladder; and (b) the sinusoids of the liver. In the adult the portal vein and its tributaries are destitute of valves; in the fetus and for a short time after birth valves can be demonstrated in the tributaries of the portal vein; as a rule they soon atrophy and disappear, but in some subjects they persist in a degenerate form.
The portal vein (vena portæ) is about 8 cm. in length, and is formed at the level of the second lumbar vertebra by the junction of the superior mesenteric and lienal veins, the union of these veins taking place in front of the inferior vena cava and behind the neck of the pancreas. It passes upward behind the superior part of the duodenum and then ascends in the right border of the lesser omentum to the right extremity of the porta hepatis, where it divides into a right and a left branch, which accompany the corresponding branches of the hepatic artery into the substance of the liver. In the lesser omentum it is placed behind and between the common bile duct and the hepatic artery, the former lying to the right of the latter. It is surrounded by the hepatic plexus of nerves, and is accompanied by numerous lymphatic vessels and some lymph glands. The right branch of the portal vein enters the right lobe of the liver, but before doing so generally receives the cystic vein. The left branch, longer but of smaller caliber than the right, crosses the left sagittal fossa, gives branches to the caudate lobe, and then enters the left lobe of the liver. As it crosses the left sagittal fossa it is joined in front by a fibrous cord, the ligamentum teres (obliterated umbilical vein), and is united to the inferior vena cava by a second fibrous cord, the ligamentum venosum (obliterated ductus venosus).
Tributaries.The tributaries of the portal vein are:
The Lienal Vein (v. lienalis; splenic vein) commences by five or six large branches which return the blood from the spleen. These unite to form a single vessel, which passes from left to right, grooving the upper and back part of the pancreas, below the lineal artery, and ends behind the neck of the pancreas by uniting at a right angle with the superior mesenteric to form the portal vein. The lienal vein is of large size, but is not tortuous like the artery.
Tributaries.The lineal vein receives the short gastric veins, the left gastroepiploic vein, the pancreatic veins, and the inferior mesenteric veins.
The short gastric veins (vv. gastricæ breves), four or five in number, drain the fundus and left part of the greater curvature of the stomach, and pass between the two layers of the gastrolienal ligament to end in the lienal vein or in one of its large tributaries.
The left gastroepiploic vein (v. gastroepiploica sinistra) receives branches from the antero-superior and postero-inferior surfaces of the stomach and from the greater omentum; it runs from right to left along the greater curvature of the stomach and ends in the commencement of the lienal vein.
The pancreatic veins (vv. pancreaticæ) consist of several small vessels which drain the body and tail of the pancreas, and open into the trunk of the lienal vein.
The inferior mesenteric vein (v. mesenterica inferior) returns blood from the rectum and the sigmoid, and descending parts of the colon. It begins in the rectum as the superior hemorrhoidal vein, which has its origin in the hemorrhoidal plexus, and through this plexus communicates with the middle and inferior hemorrhoidal veins. The superior hemorrhoidal vein leaves the lesser pelvis and crosses the left common iliac vessels with the superior hemorrhoidal artery, and is continued upward as the inferior mesenteric vein. This vein lies to the left of its artery, and ascends behind the peritoneum and in front of the left Psoas major;