19. Superior mesenteric venogram, AP projection

To produce this study a percutaneous, trans-hepatic approach was used to place a catheter in an intrahepatic branch of the portal vein. The catheter was advanced (retrograde) into the superior mesenteric vein and injected with contrast.

The portal vein drains venous blood from the GI tract, biliary system, pancreas, and spleen into the liver. It is formed by the union of the superior mesenteric vein and splenic vein (whose point of confluence is suggested on this study, although the blood in the splenic vein has not been opacified). This union occurs behind the neck of the pancreas, at the level of the L1-L2 intervertebral disc. It runs superiorly and to the right to enter the liver at the porta hepatis, where it divides into right and left branches. (See Image #18, spleno-portogram).

The patient has duplication of the left renal collecting system (i.e., the upper and lower poles of the kidney drain into separate systems). This is a common congenital anomaly.