The hepatic veins carry oxygendepleted blood from the liver to the inferior vena cava. In the centre of each segment there is a branch of the portal vein, hepatic artery and bile duct. The hepatic vein variants had high frequency 45% n45, while hepatic veins were identified in 41% n41. In total, 66 patients out of 100 had at least one abdominal vein variant and anomalies. Variant hepatic arterial anatomy radiology reference. Incidence, patterns, and clinical relevance of variant portal vein anatomy. In segment iv, the paraumbilical vein, the most common location of an intrahepatic portosystemic shunt, emerges from the anteromedial. The following observations were made in association with the portal vein variant. Variation in hepatic arterial anatomy is seen in 4045% of people. Hepatic vein definition of hepatic vein by medical. The most common hepatic venous variant was an accessory right inferior hepatic vein.
The vein that takes blood from the liver to the inferior vena cava. The impact of hepatic venous anatomic variations on hepatic resection and transplantation is the least understood aspect of liver surgery. A gallery of normal anatomical variants for trainees revising for the first frcr anatomy exam a normal variant is an atypical finding that is seen in a percentage of the population, which generally has no clinical significance, and is considered within the spectrum of normal findings. Normal variant reidels lobe liver anatomy left lobe. The portal vein or hepatic portal vein is a blood vessel that carries blood from the gastrointestinal tract, gallbladder, pancreas and spleen to the liver. We evaluated the incidence of variations of the middle hepatic vein mhv branches and their impact on formal right hepatectomy for livingdonor liver transplantation.
The veins that drain the gastrointestinal organs parallel the major arteries that supply the foregut, midgut, and hindgut, including the celiac, superior mesenteric, and the inferior mesenteric arteries respectively. Anatomic features of independent right posterior portal. In humans, it is located in the right upper quadrant of the abdomen, below the diaphragm. One of the hepatic veins has been shown draining directly into the right ventricle. Hepatic vein article about hepatic vein by the free dictionary. After occlusion of a variant hepatic artery, flow to the contralateral hepatic lobe is rapidly restored through collateral vessels. Blood pressure reading taken after ventricular relaxation. Incidence, patterns, and clinical relevance of variant. In its ascent to the heart, the inferior vena cava passes along a groove in the posterior side of the liver, and it. Approximately 75% of total liver blood flow is through the portal vein, with the remainder coming from the hepatic artery proper. A case has been described in which an accessory vein, arising from three roots, from the right lobe of the liver coursed adjacent to the inferior vena cava to. Illustrated anatomical parts with images from eanatomy and descriptions of anatomical structures.
There may be an early bifurcation, early trifurcation or even multiple right hepatic veins entering the ivc. The celiac vein drains the foregut structures, including the stomach. If you would like a large, unwatermarked image for your web page or blog, please purchase the appropriate license. Hepatic vein, any of a group of veins that transports blood from the liver to the inferior vena cava, which carries the blood to the right atrium of the heart. To evaluate the distribution and clinical value of accessory hepatic veins ahvs, we investigated the number and caliber of the ahvs and the angles between the shafts of ahvs and inferior caval vein. Therefore, in cases of variant hepatic arterial anatomy, the variant artery can be ligated, and the restored flow through the remaining dominant hepatic artery eliminates the need to implant separate infusion pumps. Intermediate hepatic vein left hepatic vein right hepatic vein. The underlying conditions favoring or precipitating hepatic vein or inferior vena cava thrombosis must be recognized and treated. Varied in size lies in the epigastric and left hypochondriac regions divided into lateral and medial segments by the left hepatic vein liver anatomy left lobe liver anatomy. The hepatic vein carries deoxygenated blood from the liver back to the right atrium of the heart via the inferior vena cava. These veins eventually convene at the portal vein, forming a single venous inflow tract into the liver.
Surgical anatomy of the vasculobiliary apparatus at the. The surgical liver anatomy is based today on the liver segmental classification established by couinaud in 1957. The complexity of hepatic interventions now performed by. Variant portal vein anatomy is nearly as common as variant hepatic artery anatomy.
We analyzed the anatomical dissections, serial transverse and coronal sections 0. Learn vocabulary, terms, and more with flashcards, games, and other study tools. In this first variant of the procedure, the anterior aspect of the suprahepatic ivc is exposed and the space between the right hepatic vein rhv and the middle hepatic vein mhv is dissected along the ivc axis for 23 cm, and when the dissection is complete, the hepatic parenchyma is looped up with a tape. We performed a detailed anatomical imaging study in rats and mice to allow for further refinement of experimental surgical approaches. Introduction the intrahepatic vascular anatomy in rodents, its variations and corresponding supplying and draining territories in respect to the lobar structure of the liver have not been described. Essential functional hepatic and biliary anatomy for the. The liver is an organ only found in vertebrates which detoxifies various metabolites, synthesizes proteins and produces biochemicals necessary for digestion and growth. The incidence of hepatic adenomas is unknown, with studies showing migration from the classically described female predominance related to the use of oral contraceptives to an increased prevalence in men, particularly recognizing that obesity and metabolic syndrome are emerging risk factors for adenomas 18 hepatic adenoma is traditionally considered the most. A blood vessel that drains blood from the liver into the inferior vena cava explanation of hepatic vein. In human anatomy, the hepatic veins are the blood vessels that drain deoxygenated blood from the liver and blood cleaned by the liver from the stomach, pancreas, small intestine and colon into the inferior vena cava they arise from the substance of the liver, more specifically the central vein of the liver lobule. Fifty consecutive patients who underwent hepatic multidetector row computed tomography ct were evaluated. On normal anatomy, typically, the splenic vein sv joins the superior mesenteric vein smv anteriorly to the ivc and posteriorly to the pancreatic neck to form the pv, which ascends within the hepatoduodenal ligament, posteriorly to the hepatic artery and common bile duct, toward the hepatic hilum, where it divides into right and left fig. Hepatic veins article about hepatic veins by the free.
Pdf variant anatomy of the hepatic artery in adult kenyans. Intrahepatic vascular anatomy in rats and micevariations. Hence this may make it difficult to accurately deduce segmental anatomy of the liver. Inside the liver, central veins directly drain the sinusoids, the central veins then join into interlobular veins. Although the falciform ligament is often thought to divide the liver into a right and left lobe, the true anatomic or surgical right and left lobes of the liver are defined by the course of the middle hepatic vein that runs through the main scissura of the liver. Vein that drains the stomach and empties into the hepatic portal vein. Couinaud classification the couinaud classification of liver anatomy divides the liver into eight functionally indepedent segments. These two tests can show the anatomy of the liver with remarkable resolution and reveal the presence of hepatic vein thrombosis. Hepatic vein article about hepatic vein by the free. The michel classification of hepatic arterial variant anatomy is illustrated in table 444. The complexity of hepatic interventions now performed by interventional radiologists and surgeons, including portal vein embolization, anatomic resection, and transplantation, make recognition and understanding of normal and variant portal vein anatomy. Variations in anatomy of the middle hepatic vein and their. Hepatic vein definition of hepatic vein by the free. A prospective threedimensional computed tomography study was undertaken on 200 consecutive subjects with normal livers to determine the prevalence of surgically significant hepatic venous anatomic variations.
In this study the normal anatomy of hepatic arterial system was seen in 66 out of 70 cadavers 94. Sometimes the cause of the liver failure may not be obvious and a liver biopsy is indicated. Hence this may make it difficult to accurately deduce segmental anatomy of. A hepatic vein is any of the veins that carry oxygen depleted blood out of the liver and into the inferior vena cava.
In the periphery of each segment there is vascular outflow through. There are several variants affecting the pv, and quite a number of congenital and acquired pathologies. Parenchyma the liver substance the liver is comprised of two main lobes, a large right lobe, and a smaller left lobe. The right hepatic vein may pass through the caval diaphragmatic opening before joining the vena cava.
Variant anatomy the right hepatic vein is a single dominant vein in 70% range 6078% of individuals. Classic branching of the common hepatic artery from the celiac artery, and the proper hepatic artery into right and left hepatic arteries to supply the entire liver, is seen in 5560% of the population. Obstruction of this vein can be caused by a tumor or growth pressing on the vessel, or by a clot in the vessel hepatic vein thrombosis most often, it is caused by conditions that make blood clots more likely to form, including. They also transport blood that has been drained from the colon, pancreas, small intestine, and the stomach.
A knowledge of the anatomy of the minor hepatic veins becomes more clinically valuable as the number of complex dissections of the retrohepatic areas, hepatectomies, and hepatic transplantations grow. Ct may also reveal the presence of any cancer causing obstruction of the hepatic vein. Anatomy, abdomen and pelvis, portal venous system hepatic. Each segment has its own vascular inflow, outflow and biliary drainage.
Hepatic veins anatomy, medical imaging and elearning. The portal vein pv is the main vessel of the portal venous system pvs, which drains the blood from the gastrointestinal tract, gallbladder, pancreas, and spleen to the liver. The study on sectional anatomy and imaging of accessory. Hepatic portal vein carries blood and nutrients from the stomach, spleen, intestines and gall bladder to the liver. Its other roles in metabolism include the regulation of glycogen storage, decomposition of red blood cells and the. You may not embed one of our images on your web page without a link back to our site. The term vein refers to a blood vessel that transports blood back to the heart, in contrast to an artery, which carries blood away from the heart. In 57% liver specimens, the anatomy of one or two structures was variant and individual variation of hepatic artery, bile duct and portal vein anatomy was observed in. Hepatic vein obstruction prevents blood from flowing out of the liver and back to the heart. One of the veins which drains blood from the liver. We observed a high prevalence of surgically important vascular variants in living adult candidates for living. The classic hepatic arterial anatomy, characterized by the proper hepatic artery dividing into right and left hepatic arteries, is observed in approximately 55% of the population figure 446. This blood contains nutrients and toxins extracted from digested contents.
420 812 753 1532 422 1146 639 1179 678 341 1468 1478 288 756 933 489 431 1239 1374 1292 351 527 1256 223 1050 129 1233 1295 1270 1442 372 1152