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Portal Venous System

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REVIEW OF LITERATURE
HISTORY OF THE PORTAL SYSTEM
384-322 BC - Aristoteles was the first person who described about portal vein(PV).
300-250 BC - Herophilos recognized the importance of portal venous system in acting as the zone of discharge for all the resorbent veins from the intestine
129-199AD - Galenus described the portal venous system along with the intrahepatic branches
1597-1677 - Glisson demonstrated the independent nature of portal venous circulation from rest of the blood circulation
ANATOMY OF THE PORTAL VENOUS SYSTEM
The system of veins that transport blood from of the spleen, alimentary tract, pancreas along with the gallbladder constitute the portal venous system. It is a valveless system that enters the liver via the porta …show more content…

The portal venous pressure is around 3-7 mmHg which is dependent on various criteria like “posture, increased intra-abdominal pressure like in coughing, compression , respiration, Valsalva’s manoeuvre and a number of biochemical mediators”1. Whereas the blood flow in the portal system is around 1000–1200ml/min and it contributes to around 72% of total supply of oxygen to the liver. The content of oxygen in the portal venous system is lower than the arterial blood, but it is at the same time significantly higher compared to that of the rest of venous system. There is never a consistent pattern of the hepatic distribution of portal blood.
PORTAL HYPERTENSION - DEFINITION
An elevated pressure of more than 12 mmHg in the portal venous circulation with the portal vein diameter of more than 13 mm or an increased gradient of more than 7mmHg in the portal system (difference between pressure in the portal vein and to that of the pressure in the inferior vena cava) is termed as portal hypertension(PHT).
According to hemodynamic application based on the Ohm's Law, “ portal pressure gradient (ΔP) is actually directly proportional to amount of blood flowing in the portal vein (Q) and the resistance opposing this flow (R) (ΔP = Q × R)”2. Thus the elevated portal pressure will be considered secondary to the increase in resistance to flow or due to the increase in blood flow, or due to both

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