 Dr. Sanjeev Sanyal, professor and department chair. In this section, I'm going to demonstrate the portal vein. The post-GMO structure in the extravatic portal triad. This is the portal vein. The portal vein is formed by the union of two great veins. The first vein that we see here, this is the supramacentric vein, which drains the midcut. And the other vein which forms a portal vein is this vein here. This is the splenic vein. The splenic vein normally runs behind the pancreas. So therefore, we cannot see it and therefore we have retracted the pancreas to show the splenic vein. It comes from the hyalum of the spleen and this vein brings so-called dirty blood from the broken down products of RBCs and the blood elements from the spleen and it is transmitted to the portal vein. The supramacentric vein carries the nutrient-rich blood from the midcut and it unites. This point of union occurs exactly behind the neck of the pancreas. This is the head of the pancreas and following that is the neck of the pancreas. And then the portal vein runs upwards and to the right. It runs in the free margin of the hepatodeodontal ligament or the lesser momentum as the post-GMO structure and then it enters the porta-hypatis. In the porta-hypatis it divides into a right and a left portal vein and the left portal vein has communications with the parambilical vein which runs in the free margin of the calcium omeligament and that forms an important site of porta-systemic anastomosis. The portal vein also receives this vein. This is the inferior miscentric vein which drains the hindgut. The inferior miscentric vein normally opens into the sprenic vein. It can open to the sprenic vein very close to the spleen or it can open to the sprenic vein very close to the superior miscentric vein. In this case we notice that it is opening into the superior miscentric vein itself. There are some important clinical correlations about this portal vein. In the earlier days in order to visualize the portal vein we had to do an investigation known as splenoportovinogram for that we used to inject a dye through the spleen and it is to fill up the sprenic vein and the portal vein and then we used to take images but that was a very traumatic procedure. So therefore nowadays when MR vinogram, magnetic resonance vinogram and therefore that we can see the full venous structure. The next important clinical correlation is when the person is suffering from alcoholic cirrhosis of the liver and there is portal hypertension when the pressure of the blood inside the portal vein is very high. Then one of the most important presentations of that is esophageal varices. Patient has hematomasis, vomiting of blood and therefore we need to decompress the portal vein. One of the procedures is to shunt some of the blood from the portal system into the systemic circulation. One of the methods of doing so is to connect the portal vein with the inferior vena keva. This is known as the portal keval shunt. There are different techniques of doing it but this is the principle. There is yet one more method of doing it and that is again because of anatomical proximity. We can anastomose the splinic vein with the left renal vein. This is the left renal vein and they are not very far apart. So therefore there are again many different technical varieties of doing it but the principle is same. This is known as the splino renal shunt. So these are two of the many ways, numerous ways by which we can shunt blood from the portal system into the systemic circulation and therefore decompress the esophageal varices and reduce the portal hypertension. Thank you very much for watching. Dr. Sanjay Sanyal is signing out. If you have any questions or comments please put them in the comment section below. Have a nice day. So guys thanks for watching. Make sure you subscribe. Make sure you like this video.