Left gastric vein
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View Travis Fahrenhorst-Jones's current disclosures- Coronary vein
The left gastric vein (also known as the coronary vein) drains both the anterior and posterior gastric walls. It forms a loop with the right gastric vein at the lesser curvature of the stomach. The left gastric vein travels in the lesser omentum to drain in the portal vein. It also communicates with the lower esophageal veins through several anastomotic channels.
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Gross anatomy
Origin and course
The left gastric vein begins as small venous branches draining the anterior and posterior walls of the lesser curvature of the stomach 5. The left gastric vein then ascends along the lesser curvature of the stomach within the lesser omentum (specifically the hepatogastric ligament) to the esophageal hiatus where it anastomoses with the esophageal veins 5. The vessel then descends along the gastropancreatic fold draining into the portal vein at the superior border of the pancreas1.
Relations
Typically the left gastric vein will travel dorsal to the common hepatic artery and ventral relative to the splenic artery 1.
Tributaries
- anterior branches - draining esophageal veins 5
- posterior branches - draining paraesophageal veins 5
Variant anatomy
The course and relation to the surrounding vessels of the left gastric vein can vary 1-3. This includes drainage directly into the liver 4,7.
Clinical importance
The left gastric vein may be damaged during lymph node dissection or gastrectomy which may cause massive hemorrhage 1,2. In addition, the vessel is a frequent site for collateralization between the systemic and portal venous systems in instances of portal hypertension as well as splenoportal collateralization in cases of splenic vein occlusion 6.
References
- 1. Huang CM, Wang JB, Wang Y, Zheng CH, Li P, Xie JW, Lin JX, Lu J. Left gastric vein on the dorsal side of the splenic artery: a rare anatomic variant revealed during gastric surgery. Surg Radiol Anat. 2014 Mar;36(2):173-80. doi:10.1007/s00276-013-1154-9 - Pubmed
- 2. Hayemin Lee, Junhyun Lee. Anatomic variations in the left gastric vein and their clinical significance during laparoscopic gastrectomy. (2019) Surgical Endoscopy. 33 (6): 1903. doi:10.1007/s00464-018-6470-z
- 3. Yongyou Wu, Guangqiang Chen, Pengfei Wu, Jianbin Zhu, Wei peng, Chungen Xing. CT imaging-based determination and classification of anatomic variations of left gastric vein. (2017) Surgical and Radiologic Anatomy. 39 (3): 249. doi:10.1007/s00276-016-1722-x
- 4. Ohkubo, M. (2000), Aberrant left gastric vein directly draining into the liver. Clin. Anat., 13: 134-137. doi:10.1002/(SICI)1098-2353(2000)13:2
- 5. Richard M. Gore, Marc S. Levine. Textbook of Gastrointestinal Radiology. (2021) ISBN: 9780323640824
- 6. Kim ST, Nemcek AA, Ferral H, Vogelzang R. Angiography and Interventional Radiology of the Hollow Viscera. 2014. In: Richard M. Gore, Marc S. Levine. Textbook of Gastrointestinal Radiology. (2021) ISBN: 9780323640824
- 7. Unal E, Ozmen MN, Akata D, Karcaaltincaba M. Imaging of aberrant left gastric vein and associated pseudolesions of segments II and III of the liver and mimickers. Diagn Interv Radiol. 2015;21(2):105-110. doi:10.5152/dir.2014.14360
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