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Old Sunday, May 17, 2009
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Hepatic portal system

In human anatomy, the hepatic portal system is the system of veins comprised of the hepatic portal vein and its tributaries. It is also called the portal venous system, although it is not the only example of a portal venous system, and splanchnic veins, which is not synonymous with hepatic portal system and is imprecise (as it means visceral veins and not necessarily the veins of the abdominal viscera).

Function

The portal venous system is responsible for directing blood from parts of the gastrointestinal tract to the liver. Substances absorbed in the small intestine travel first to the liver for processing before continuing to the heart. Not all of the gastrointestinal tract is part of this system. The system extends from about the lower portion of the esophagus to the upper part of the anal canal. It also includes venous drainage from the spleen and pancreas.
Many drugs that are absorbed through the GI tract are substantially metabolized by the liver before reaching general circulation. This is known as the first pass effect. As a consequence, certain drugs can only be taken via certain routes. For example, nitroglycerin cannot be swallowed because the liver would inactivate the medication, but it can be taken under the tongue or transdermal (through the skin) and thus is absorbed in a way that bypasses the portal venous system.
Blood flow to the liver is unique in that it receives both oxygenated and deoxygenated blood. As a result, the partial pressure of oxygen (pO2) and perfusion pressure of portal blood are lower than in other organs of the body. Blood passes from branches of the portal vein through cavities between "plates" of hepatocytes called sinusoids. Blood also flows from branches of the hepatic artery and mixes in the sinusoids to supply the hepatocytes with oxygen. This mixture percolates through the sinusoids and collects in a central vein which drains into the hepatic vein. The hepatic vein subsequently drains into the inferior vena cava.
Large veins that are considered part of the portal venous system are the:
Hepatic portal vein
Splenic vein
Roughly, the portal venous system corresponds to areas supplied by the celiac trunk, the superior mesenteric artery, and the inferior mesenteric artery.








The hepatic portal system begins in the capillaries of the digestive organs and ends in the portal vein. Consequently, portal blood contains substances absorbed by the stomach and intestines. Portal blood is passed through the hepatic lobules where nutrients and toxins are absorbed, excreted or converted.
Restriction of outflow through the hepatic portal system can lead to portal hypertension. Portal hypertension is most often associated with cirrhosis. Patients usually present with splenomegaly, ascites, GI bleeding and/or portal systemic encephalopathy.
The consequences of portal hypertension are due to portal systemic anastomosis formed by the body as an attempt to bypass the obstructed liver circulation. These collateral vessels form along the falciform ligament, diaphragm, spleen, stomach and peritoneum. The collaterals find their way to the renal vein where blood drained from the digestive organs is let into the systemic circulation.
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