Portosystemic Anastomosis

Portosystemic connections are present in

Gastroesophageal area

Between the esophageal tributary of the left gastric vein and the esophageal tributaries of the azygos vein


Between the superior, middle, and inferior rectal veins

Around the umbilicus

Between the left portal, umbilical, and paraumbilical veins and the superficial and deep epigastric veins


Between the colic and splenic veins and renal and posterior parietal veins

What is portocaval anastomosis?

Porto-systemic anastomosis also known as portocaval anastomosis is the collateral communication between the portal and the systemic venous system.

Lower esophagusAnastomosis between – Left gastric veins (portal system) and lower branches of oesophageal veins (systemic veins)
Upper part of anal canalAnastomosis between – Superior rectal veins (portal) and inferior and middle rectal veins (systemic)
UmbilicusAnastomosis between – Paraumbilical veins (portal) and epigastric veins (systemic)
Area of the liverAnastomosis between – Intraparenchymal branches of right division of portal vein (portal) and retroperitoneal veins (systemic)
Hepatic and splenic flexuresAnastomosis between – Omental and colonic veins (portal) and retroperitoneal veins (systemic)
Hepatic and splenic Anastomosis between – Ductus venosus (portal) and inferior vena cava (systemic)
Function of the porto-systemic anastomosisProvide alternative routes of venous blood circulation when there is a blockage in the liver or portal vein.
Ensure that venous blood from the gastrointestinal tract still reaches the heart through the inferior vena cava without going through the liver.
portocaval anastomosis

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