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Portal hypertension is a condition in which the blood pressure of the portal venous system is too high. It is often the result of cirrhosis of the liver. Liver cirrhosis can lead to increased intrahepatic vascular resistance and vasodilation of portal system arteries, both of which increase pressure in the portal vein. [ 4 ]
Approximately 75% of total liver blood flow is through the portal vein, with the remainder coming from the hepatic artery proper. The blood leaves the liver to the heart in the hepatic veins . The portal vein is not a true vein , because it conducts blood to capillary beds in the liver and not directly to the heart.
The human hepatic portal system delivers about three-fourths of the blood going to the liver.The final common pathway for transport of venous blood from spleen, pancreas, gallbladder and the abdominal portion of the gastrointestinal tract [2] (with the exception of the inferior part of the anal canal and sigmoid colon) is through the hepatic portal vein.
In histology (microscopic anatomy), the lobules of liver, or hepatic lobules, are small divisions of the liver defined at the microscopic scale. The hepatic lobule is a building block of the liver tissue, consisting of a portal triad, hepatocytes arranged in linear cords between a capillary network, and a central vein.
Portal hypertension is defined as increased portal venous pressure, with a hepatic venous pressure gradient greater than 5 mmHg. [3] [4] Normal portal pressure is 1–4 mmHg; clinically insignificant portal hypertension is present at portal pressures 5–9 mmHg; clinically significant portal hypertension is present at portal pressures greater than 10 mmHg. [5]
The caudate lobe is a separate structure which receives blood flow from both the right- and left-sided vascular branches. [5] [6] The Caudate lobe includes: (1) the Spiegel lobe; (2) the paracaval portion; and (3) the caudate process portion. The Spiegel lobe has its portal venous and biliary branches ramified mainly from the left-side tract.
Blood flow through the left coronary artery is at a maximum during diastole (in contrast to the rest of systemic circulation, which has a maximum blood flow during systole.) splanchnic circulation: 15%: low: Flow increases during digestion. hepatic circulation: 15%: Part of portal venous system, so oncotic pressure is very low renal circulation ...
The splenic vein is formed from small venules that leave the spleen. It travels above the pancreas, alongside the splenic artery.It collects branches from the stomach and pancreas, and most notably from the large intestine (also drained by the superior mesenteric vein) via the inferior mesenteric vein, which drains in the splenic vein shortly before the origin of the hepatic portal vein.