Anatomic Variations of the Right Portal Vein: Prevalence, Imaging Features, and Implications for Successful Transjugular Intrahepatic Portosystemic Shunt Creation

Gunasekaran, Senthil S.; Gaba, Ron C.

doi:10.4103/jcis.jcis_10_17

Cited by 9 publications

(13 citation statements)

References 11 publications

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“…The supply to segment VI via the isolated branch of RPV (Figure 5 ) was recorded in 16 patients (3.2%). Covey et al and Gunasekaran and Gaba also depicted type 5 as the more common pattern than type 4, corresponding to our finding [ 11 , 13 ].…”

Section: Discussionsupporting

confidence: 91%

“…Branch to segment VII arising separately from RPV (Figure 4 ) was noted in 1.2% cases, identical to frequencies described by Covey et al and Gunasekaran and Gaba [ 11 , 13 ]. The supply to segment VI via the isolated branch of RPV (Figure 5 ) was recorded in 16 patients (3.2%).…”

Section: Discussionsupporting

confidence: 84%

“…Some of these channels revert and others evolve as programmed genetically to generate the conventional portal vein and its branches. Deviations in this scripted evolution leads to morphologically distinct patterns [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

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Role of CT Imaging With Three-Dimensional Maximum Intensity Projection Reconstruction in the Evaluation of Portal Vein Variants at a Tertiary Care Hospital

Ullah

Ahmed

Hamid

et al. 2020

Cureus

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Introduction: Portal vein (PV) is the principal blood vessel transporting blood from the alimentary tract and spleen to the liver. The aim of this study is to determine the prevalence of PV anatomical variations in our population using multidetector CT with maximum intensity projection (MIP) technique at a tertiary care hospital. Methods: This cross-sectional study was prospectively conducted from November 2018 to June 2019 in the Department of Radiology at a tertiary care hospital in Karachi. After informed consent, all the patients with no known hepatic pathology undergoing routine abdomen CT were included in this study. Patients with previous hepatic resection surgeries, undiagnosed large hepatic tumors/metastasis, and those with PV thrombosis were excluded. Results: A total of 500 patients (256 males and 244 females) were included in the study; the mean age of female patients was relatively higher as compared to the male patients (53.80 ± 18.44 vs. 44.15 ± 19.94 years; p = 0.000). Standard PV anatomy (type 1) was found in 438 patients (87.6%). Trifurcation (type 2) occurred in 18 patients (3.6%). Right posterior portal vein as the first branch of main PV (type 3) was found in 22 patients (4.4%). A separate branch of the right portal vein (RPV) to segment VII (type 4) and separate branch of the RPV to segment VI (type 5) were found in 6 (1.2%) and 16 (3.2%) patients, respectively. Conclusion: Our study displayed a relatively higher frequency of standard PV anatomy (type 1) compared to previous studies. We highlight the role of MIP in the analysis of hepatic venous anatomy with its utility demonstrating improved detection of variations.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 84%

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Role of CT Imaging With Three-Dimensional Maximum Intensity Projection Reconstruction in the Evaluation of Portal Vein Variants at a Tertiary Care Hospital

Ullah

Ahmed

Hamid

et al. 2020

Cureus

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“…The right vitelline vein forms the right PV, the left vitelline vein forms a ventral anastomosis with the left PV, and the left vitelline vein forms the main PV. Variations in the growth of the venous plexus and selective involution lead to PV variance [ 5 ].…”

Section: Reviewmentioning

confidence: 99%

Portal Vein Variations, Clinical Correlation, and Embryological Explanation: A Review Article

Tyagi¹,

Jha²

2023

Cureus

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Portal vein (PV) is a large vein that collects blood from the abdominal part of gall bladder, pancreas, alimentary tract, and spleen and transports to the liver. One of the parts of the extraembryonic venous system, the vitelline veins, is where PV starts. In about five weeks of gestation, a venous plexus is formed, and variations in this plexus lead to portal variance. The junction of superior mesenteric and splenic veins is typically where the vein begins to network. There are five types of branching patterns of the right PV: conventional branching, trifurcation branching, early branching, separate segment 7 branching, and separate segment 6 branching. To perform pancreatic, duodenal, and liver surgeries, knowledge of variations in PV formation is important. For surgical and interventional operations to be accurate, it is crucial to understand the architecture of the PV and its anomalies. As distinct regions of the brain connect with one another, portal architecture is frequently observed in imaging investigations. Portal hypertension is characterized as an increase in blood pressure in the portal venous system (PVS) in the context of severe liver disease, such as cirrhosis. Non-invasive methods for examining the anatomy and anomalies of the PV include ultrasound, computed tomography (CT), and magnetic resonance (MR). There are many abnormalities of PVS that have been discussed in the articles such as Congenital PV Absence; PV Branches Congenitally Grow in Structure; Hypoplasia, Atresia, and Stenosis of the PV; and Portosystemic Shunts.

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“…At 10 weeks’ gestational age, the main portal vein (MPV) is formed by the left vitelline vein and the dorsal component, the left portal vein (LPV) arises from the left vitelline vein and ventral anastomoses and the right portal vein (RPV) emerges from the right vitelline vein. Deviations from this pattern lead to numerous anatomical variants [ 6 , 12 , 13 ].…”

Section: Trifurcation Of Pvmentioning

confidence: 99%

Duplicated inferior vena cava-trifurcated portal vein: a rare anatomical variation encountered during Whipple procedure

Chrysikos

Delis

Smerdi

et al. 2023

Journal of Surgical Case Reports

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The inferior vena cava (IVC) is the largest single vein in humans. However, during embryogenesis, abnormalities can occur resulting in a duplicated IVC. The portal vein (PV) offers the main blood flood to the liver, forming by the left and right PV. A number of anatomical variations are noticed, underlying the great importance of the pre-operative imaging workup. This case report presents a duplicated IVC and a trifucated PV that were incidentally found in an 82 year-old Caucasian male with pancreatic ductal adenocarcinoma who underwent pancreatoduodenectomy (Whipple procedure). Although some anatomical variations, including the duplication of the IVC and the trifurcation of PV, may be rare to the general population, the suspicion of their existence should always be taken under consideration from surgeons during hepatobiliary or retroperitoneal operations.

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Anatomic Variations of the Right Portal Vein: Prevalence, Imaging Features, and Implications for Successful Transjugular Intrahepatic Portosystemic Shunt Creation

Cited by 9 publications

References 11 publications

Role of CT Imaging With Three-Dimensional Maximum Intensity Projection Reconstruction in the Evaluation of Portal Vein Variants at a Tertiary Care Hospital

Role of CT Imaging With Three-Dimensional Maximum Intensity Projection Reconstruction in the Evaluation of Portal Vein Variants at a Tertiary Care Hospital

Portal Vein Variations, Clinical Correlation, and Embryological Explanation: A Review Article

Duplicated inferior vena cava-trifurcated portal vein: a rare anatomical variation encountered during Whipple procedure

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