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Vasculature of the Gut

Arterial supply

Gastrointestinal tract
Venous drainage

Arterial Supply

3 large unpaired arteries

Abdominal part of gastrointestinal tract Structures derived from this part during development liver, pancreas, gall bladder Pass through derivatives of dorsal and ventral mesenteries Supply spleen and lymph nodes that develop in the mesenteries.

Arterial supply

3 major arteries arise from front of abdominal aorta

T12 -L1

Coeliac axis
L1-L2

Foregut

Arteries

Superior mesenteric A. L3 Inferior mesenteric A.

Mid gut Hind Gut

Relationship of vessels to mesenteries

Arterial supply

Branches of Aorta

Coeliac Trunk

As it arises it divides into branches Left gastric Oesophageal branches anastomose with similar Branches of thoracic aorta Supplies both surfaces of Lesser curvatrure Anastomose with right gastric branch

Splenic artery

short gastric arteries fundus of the stomach greater curvature


hepatic artery proper

left gastro epiploic artery

Common hepatic artery

Gastro duodenal artery

right hepatic left hepatic

right gastro epiploic superior pancreatico duodenal

Blood supply - Stomach

Blood supply - Stomach

Blood supply Biliary tree

Superior mesenteric artery


Anterior to lower part of L1 Inferior pancreatico duodenal Jejunal Ileal From main trunk Middle colic Right colic Ileo colic

Branches of superior mesenteric artery

Jejunum

Ileum

Inferior Mesenteric Artery

Arise from front of aorta Smallest branch Anterior to body of L3 Branches

Hind gut

Left colic Sigmoid Superior rectal

Branches of inferior mesenteric artery

Venous drainage
Spleen Pancreas Gall bladder Gastrointestinal tract (except lower rectum)

portal vein

sinusoids
sublobular vein

IVC

hepatic vein

Portal vein

Splenic vein

Superior mesenteric vein

Behind the Portal vein at L2 neck of pancreas posterior superior part of duodenum Ant- epiploic foramen Post- bile duct hepatic artery right margin of lesser omentum

Liver

Tributaries of portal vein

right and left gastric veins

lesser curvature abd .oesophagus

cystic vein gall bladder Para umbilical vein associated with obliterated umbilical vein connect to veins of anterior abdominal wall

Splenic vein

Numerous small vessels at hilum of spleen in spleno- renal ligament

Splenic artery Tail of pancreas behind body of pancreas

arge splenic vein


superior mesenteric artery portal vein

Behind neck

Tributaries to splenic vein

Short gastric vein

Fundus of stomach left part of greater curvature left gastro-epiploic vein greater curvature pancreatic veins body and tail of pancreas Inferior mesenteric vein rectum, sigmoid colon splenic flexure left colic vein sigmoid veins

Superior rectal vein

Superior mesenteric vein

Drain blood from

Begins in the right iliac fossa

Small intestine Caecum Ascending colon Transverse colon Terminal ileum Appendix

Corresponding vein accompanies each branch of superior mesenteric artery .

Tributaries of superior mesenteric vein


Jejunal veins Ileal veins Ileocolic right colic vein Middle colic vein Right gastro epiploic (omental) vein Anterior and posterior inferior pancreatico- duodenal veins

Porto- systemic anastomosis

At gastro oesophageal junction around cardia


left gastric vein azygos system of caval system middle and inferior rectal veins

portal

at the anus portal superior rectal vein

internal iliac vein

internal pudendal vein

Around umbilicus anterior abdominal wall portal para umbilical veins of anterior veins abdominal wall

At bare area of liver portal channels across bare area

azygos system above diaphragm

When the pressure in portal vein is elevated

venous enlargement- varices around sites of porto systemic anastomosis Hemorrhoids ano-rectal junction bleeding Oesophageal varices lower end of oesophagus Caput medusae around umbilicus

Porto - Systemic anastomosis

In normal individuals 100% of portal venous blood flow can be recovered from hepatic veins In patients with portal hypertension commonly in cirrhocis less blood flow to the liver
Blood enters collateral channels circulation at specific points systemic