Splenic vein
Confluence · Foregut Hindgut
Formed at the splenic hilum from several tributaries, it runs to the right in the splenorenal ligament and then behind the body and tail of the pancreas, below the splenic artery and in front of the left kidney and left renal vein, receiving the short gastric, left gastro-omental, pancreatic and (classically) inferior mesenteric veins. Behind the neck of the pancreas it joins the superior mesenteric vein to form the portal vein.
Traced from the start
Detail
- Course
- Retropancreatic, below the splenic artery, anterior to the left kidney and left renal vein
- Tributaries
- Short gastric, left gastro-omental, pancreatic and inferior mesenteric veins
- Valves
- None, like the rest of the portal system
When it goes wrong
Splenic vein thrombosis from acute or chronic pancreatitis, a pseudocyst or pancreatic carcinoma
Sinistral (left-sided) portal hypertension: splenomegaly and isolated gastric varices with a patent portal vein and normal liver function; splenectomy is curative
Sustained portal hypertension transmitted back into the splenic vein
Congestive splenomegaly with hypersplenism: thrombocytopenia, leucopenia and anaemia
Distal splenorenal (Warren) shunt
Splenic vein anastomosed to the left renal vein decompresses gastro-oesophageal varices selectively while preserving portal flow to the liver
Practise this structure
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