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Blood supply and venous drainage of the gastro-intestinal tract and liver

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Blood supply and venous drainage of the gastro-intestinal tract and liver

  1. 1. Blood supply and venous drainage of the gastro-intestinal tract and liver Raymond G Buick Paediatric Surgeon Birmingham UK
  2. 2. alimentary tract
  3. 3. alimentary tract
  4. 4. alimentary tract
  5. 5. Gastro-intestinal tract
  6. 6. Gastro-intestinal tract
  7. 7. Gastro-intestinal tract
  8. 8. Oesophago-gastric junction Gastro-intestinal tract
  9. 9. Oesophago-gastric junction anus Gastro-intestinal tract
  10. 10. Approximate length of the adult gut • The SMALL intestine = 7m long • The LARGE intestine = 1.5 m long • Stomach = 0.5 m • TOTAL = 9 m
  11. 11. Arterial Supply to GI Tract
  12. 12. upper and lower GI tracts
  13. 13. upper and lower GI tracts Embryological – 1 2 3
  14. 14. upper and lower GI tracts Embryological – 1 2 3 FOREHEAD BEHIND
  15. 15. upper and lower GI tracts Embryological – 1 foregut 2 3 FOREHEAD BEHIND FOREGUT
  16. 16. upper and lower GI tracts Embryological – 1 foregut 2 3 hindgut FOREHEAD BEHIND HINDGUT FOREGUT
  17. 17. upper and lower GI tracts Embryological – 1 foregut 2 midgut 3 hindgut MIDGUT HINDGUT FOREGUT
  18. 18. upper and lower GI tracts Embryological – foregut midgut hindgut HINDGUT FOREGUT MIDGUT FOREGUT HINDGUT
  19. 19. MIDGUT FOREGUT HINDGUT
  20. 20. MIDGUT FOREGUT HINDGUT
  21. 21. MIDGUT FOREGUT HINDGUT
  22. 22. MIDGUT FOREGUT HINDGUT
  23. 23. • coeliac artery • superior mesenteric artery • inferior mesenteric artery
  24. 24. • coeliac artery • superior mesenteric artery • inferior mesenteric artery
  25. 25. MIDGUT FOREGUT HINDGUT watershed watershed
  26. 26. Coeliac Artery left gastric artery – oesophageal branch – hepatic branch hepatic artery – right gastric artery – gastro-duodenal artery » right gastro-epiploic artery » superior pancreatico-duodenal artery splenic artery – left gastro-epiploic artery – short gastric arteries – pancreatic branches
  27. 27. Coeliac Artery left gastric artery oesophageal branch hepatic branch hepatic artery – right gastric artery – gastro-duodenal artery » right gastro-epiploic artery » superior pancreatico-duodenal artery splenic artery – left gastro-epiploic artery – short gastric arteries – pancreatic branches
  28. 28. Coeliac Artery left gastric artery – oesophageal branch – hepatic branch hepatic artery right gastric artery gastro-duodenal artery right gastro-epiploic artery superior pancreatico-duodenal artery splenic artery – left gastro-epiploic artery – short gastric arteries – pancreatic branches
  29. 29. Coeliac Artery left gastric artery – oesophageal branch – hepatic branch hepatic artery right gastric artery gastro-duodenal artery right gastro-epiploic artery superior pancreatico-duodenal artery splenic artery – left gastro-epiploic artery – short gastric arteries – pancreatic branches
  30. 30. Coeliac Artery left gastric artery – oesophageal branch – hepatic branch hepatic artery – right gastric artery – gastro-duodenal artery » right gastro-epiploic artery » superior pancreatico-duodenal artery splenic artery short gastric arteries left gastro-epiploic artery pancreatic branches
  31. 31. Coeliac Artery left gastric artery – oesophageal branch – hepatic branch hepatic artery – right gastric artery – gastro-duodenal artery » right gastro-epiploic artery » superior pancreatico-duodenal artery splenic artery short gastric arteries left gastro-epiploic artery pancreatic branches
  32. 32. Coeliac Artery left gastric artery – oesophageal branch – hepatic branch hepatic artery – right gastric artery – gastro-duodenal artery » right gastro-epiploic artery » superior pancreatico-duodenal artery splenic artery short gastric arteries left gastro-epiploic artery pancreatic branches
  33. 33. Coeliac Artery left gastric artery – oesophageal branch – hepatic branch hepatic artery – right gastric artery – gastro-duodenal artery » right gastro-epiploic artery » superior pancreatico-duodenal artery splenic artery – left gastro-epiploic artery – short gastric arteries – pancreatic branches
  34. 34. Coeliac Artery left gastric artery – oesophageal branch – hepatic branch hepatic artery – right gastric artery – gastro-duodenal artery » right gastro-epiploic artery » superior pancreatico-duodenal artery splenic artery – left gastro-epiploic artery – short gastric arteries – pancreatic branches
  35. 35. • coeliac artery • superior mesenteric artery • inferior mesenteric artery
  36. 36. • coeliac artery • superior mesenteric artery • inferior mesenteric artery watershed
  37. 37. Venous drainage of GI Tract
  38. 38. Venous drainage of GI Tract • Veins follow (+/-) arteries • inferior mesenteric vein drains to splenic vein • splenic vein joins superior mesenteric vein to form the portal vein
  39. 39. Venous drainage of GI Tract • Veins follow (+/-) arteries • inferior mesenteric vein drains to splenic vein • splenic vein joins superior mesenteric vein to form the portal vein
  40. 40. Venous drainage of GI Tract • Veins follow (+/-) arteries • inferior mesenteric vein drains to splenic vein • splenic vein joins superior mesenteric vein to form the portal vein
  41. 41. Venous drainage of GI Tract • Veins follow (+/-) arteries • inferior mesenteric vein drains to splenic vein • splenic vein joins superior mesenteric vein to form the portal vein
  42. 42. Venous drainage of GI Tract • Veins follow (+/-) arteries • inferior mesenteric vein drains to splenic vein • splenic vein joins superior mesenteric vein to form the portal vein
  43. 43. Venous drainage of GI Tract • Veins follow (+/-) arteries • inferior mesenteric vein drains to splenic vein • splenic vein joins superior mesenteric vein to form the portal vein
  44. 44. Venous drainage of GI Tract • Veins follow (+/-) arteries • inferior mesenteric vein drains to splenic vein • splenic vein joins superior mesenteric vein to form the portal vein
  45. 45. Venous drainage of GI Tract • Veins follow (+/-) arteries • inferior mesenteric vein drains to splenic vein • splenic vein joins superior mesenteric vein to form the portal vein porta hepatis
  46. 46. Venous drainage of GI Tract Hepatic veins Hepatic artery Portal vein IVC . .
  47. 47. Venous drainage of GI Tract • Nutritents and substances absorbed from the GI tract • Disease spread (eg tumour spread) from the GI tract to liver • Portal hypertension – varicies
  48. 48. Venous drainage of GI Tract Capillary circulation in the liver Oesophageal veins draining into left gastric vein Connection between superior rectal vein (portal) and middle rectal vein (systemic)
  49. 49. Venous drainage of GI Tract Oesophageal veins draining into left gastric vein Connection between superior rectal vein (portal) and middle rectal vein (systemic) OESOPHAGEAL VARICIES HAEMORRHOIDS
  50. 50. The End • Why don’t you take some exam questions on this topic from our MCQ’s section
  51. 51. 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