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Blood supply and venous
drainage of the gastro-intestinal
tract and liver
Raymond G Buick
Paediatric Surgeon
Birmingham UK
alimentary tract
alimentary tract
alimentary tract
Gastro-intestinal tract
Gastro-intestinal tract
Gastro-intestinal
tract
Oesophago-gastric
junction
Gastro-intestinal tract
Oesophago-gastric
junction
anus
Gastro-intestinal tract
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
Arterial Supply to GI Tract
upper and lower GI tracts
upper and lower GI tracts
Embryological – 1
2
3
upper and lower GI tracts
Embryological – 1
2
3
FOREHEAD
BEHIND
upper and lower GI tracts
Embryological – 1 foregut
2
3
FOREHEAD
BEHIND
FOREGUT
upper and lower GI tracts
Embryological – 1 foregut
2
3 hindgut
FOREHEAD
BEHIND
HINDGUT
FOREGUT
upper and lower GI tracts
Embryological – 1 foregut
2 midgut
3 hindgut
MIDGUT
HINDGUT
FOREGUT
upper and lower GI tracts
Embryological – foregut
midgut
hindgut
HINDGUT
FOREGUT
MIDGUT
FOREGUT
HINDGUT
MIDGUT
FOREGUT
HINDGUT
MIDGUT
FOREGUT
HINDGUT
MIDGUT
FOREGUT
HINDGUT
MIDGUT
FOREGUT
HINDGUT
• coeliac artery
• superior mesenteric artery
• inferior mesenteric artery
• coeliac artery
• superior mesenteric artery
• inferior mesenteric artery
MIDGUT
FOREGUT
HINDGUT
watershed
watershed
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
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
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
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
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
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
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
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
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
• coeliac artery
• superior mesenteric artery
• inferior mesenteric artery
Blood supply and venous drainage of the gastro-intestinal tract and liver
• coeliac artery
• superior mesenteric artery
• inferior mesenteric artery
watershed
Venous drainage of GI Tract
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
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
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
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
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
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
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
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
Venous drainage of GI Tract
Hepatic veins
Hepatic artery
Portal vein
IVC
.
.
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
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)
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
The End
• Why don’t you take some exam questions on
this topic from our MCQ’s section
CREDITS
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Blood supply and venous drainage of the gastro-intestinal tract and liver