In the course of the
round ligament of the liver, small paraumbilical veins are found which establish an
anastomosis between the
vein
Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenat ...
s of the
anterior abdominal wall
In anatomy, the abdominal wall represents the boundaries of the abdominal cavity. The abdominal wall is split into the anterolateral and posterior walls.
There is a common set of layers covering and forming all the walls: the deepest being the vi ...
and the
portal vein,
hypogastric, and
iliac vein
In human anatomy, iliac vein refers to several anatomical structures located in the pelvis:
* Common iliac vein, formed by the external and internal iliac veins, drains into the inferior vena cava
* Deep circumflex iliac vein, formed by the union ...
s. These veins include Burrow's veins, and the veins of Sappey – superior veins of Sappey and the inferior veins of Sappey.
The best marked of these small veins is one which commences at the
navel
The navel (clinically known as the umbilicus, commonly known as the belly button or tummy button) is a protruding, flat, or hollowed area on the abdomen at the attachment site of the umbilical cord. All placental mammals have a navel, although ...
(umbilicus) and runs backward and upward in, or on the surface of, the round ligament (ligamentum teres) between the layers of the
falciform ligament
In human anatomy, the falciform ligament () is a ligament that attaches the liver to the front body wall and divides the liver into the left lobe and right lobe. The falciform ligament is a broad and thin fold of peritoneum, its base being dire ...
to end in the left portal vein.
Pathophysiology
In cases of
portal hypertension, the paraumbilical veins may become enlarged in order to reduce hepatic portal vein pressure by shunting blood to the
superficial epigastric vein
Superficial may refer to:
*Superficial anatomy, is the study of the external features of the body
*Superficiality, the discourses in philosophy regarding social relation
* Superficial charm, the tendency to be smooth, engaging, charming, slick and ...
. The superficial epigastric vein drains to the femoral vein which ultimately drains into the inferior vena cava directly through the external iliac and common iliac vein, thereby bypassing the liver. Dilation of this particular
portacaval anastomosis
A portocaval anastomosis or porto-systemic anastomosis is a specific type of anastomosis that occurs between the veins of the portal circulation and those of the systemic circulation. When there is a blockage of the portal system, portocaval anast ...
results in what is referred to as
caput medusae
Caput medusae is the appearance of distended and engorged superficial epigastric veins, which are seen radiating from the umbilicus across the abdomen. The name ''caput medusae'' (Latin for "head of Medusa") originates from the apparent similar ...
.
References
External links
* - "Venous Drainage of the Anterior Abdominal Wall"
Veins of the torso
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