splenic vein
Summary
The splenic vein is a major portal venous tributary that drains blood from the spleen, pancreatic tail, and left side of the greater curvature of the stomach. It joins with the superior mesenteric vein to form the hepatic portal vein, making it crucial for portal circulation.
Detail
The splenic vein originates from the splenic hilum and travels along the superior border of the pancreas in a groove on the posterior surface. It receives tributaries from the short gastric veins, left gastroepiploic vein, pancreatic veins, and inferior mesenteric vein. The vein measures approximately 8-10cm in length and joins the superior mesenteric vein behind the neck of the pancreas to form the hepatic portal vein. Clinically, splenic vein thrombosis can occur due to pancreatitis, pancreatic cancer, or hypercoagulable states, leading to isolated gastric varices (left-sided portal hypertension) without esophageal varices. This creates a characteristic pattern of fundal varices that can cause upper GI bleeding. Splenic vein thrombosis may also result from compression by pancreatic masses or inflammatory processes. Unlike systemic portal hypertension, splenic vein thrombosis causes localized portal hypertension affecting only the splenic circulation, making splenectomy potentially curative.
Sources
- Gray's Anatomy
- Sleisenger and Fordtran's Gastrointestinal and Liver Disease
- Schwartz's Principles of Surgery
- First Aid for the USMLE Step 1
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