Portal Vein

vena portae hepatis

The portal vein carries nutrient-rich blood from the entire gastrointestinal tract and spleen to the liver for processing before it enters the systemic circulation. Portal hypertension from liver cirrhosis or portal vein obstruction raises portal venous pressure, producing varices at portosystemic anastomoses (oesophageal, haemorrhoidal, and periumbilical caput medusae) where portal blood can bypass the liver into systemic veins.

Region: Abdomen

Anatomical Data

Origin, Insertion & Supply

Origin	Junction of the superior mesenteric vein and splenic vein posterior to the pancreatic neck

Clinical Relevance

Clinical Notes

Portal hypertension causes oesophageal varices that rupture to produce massive upper gastrointestinal bleeding with 30 to 40 percent mortality per episode. Management includes variceal band ligation, terlipressin, Sengstaken-Blakemore tube tamponade for acute haemorrhage, and TIPS (transjugular intrahepatic portosystemic shunt) for refractory cases. Portal vein thrombosis can complicate pancreatitis, malignancy, and hypercoagulable states, producing mesenteric ischaemia and portal hypertension.

Pathology

Common Injuries & Conditions

Portal Hypertension

Increased portal venous pressure from cirrhosis or portal obstruction producing oesophageal varices, splenomegaly, and ascites managed with beta-blockers, band ligation, and TIPS for refractory cases.