Is the splenic vein located on the same side of the body as the portal vein and hepatic veins?

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Anatomical Location of the Splenic Vein

Yes, the splenic vein is located on the same side of the body as the portal vein and hepatic veins—all three vessels are intra-abdominal structures that exist bilaterally within the central abdomen and liver, not confined to left or right body sides.

Portal Venous System Anatomy

The splenic vein, portal vein, and hepatic veins form an interconnected venous drainage system within the abdomen:

  • The portal vein is formed by the confluence of the splenic vein and superior mesenteric vein behind the neck of the pancreas, creating the main portal trunk that enters the liver 1, 2, 3.

  • The splenic vein drains the spleen and courses along the posterior aspect of the pancreas before joining the superior mesenteric vein 4, 1.

  • The hepatic veins drain blood from the liver directly into the inferior vena cava, representing the outflow system from hepatic parenchyma 5.

Spatial Relationship Within the Body

These vessels do not occupy "sides" of the body in the traditional sense of laterality:

  • The portal vein and its tributaries (including the splenic vein) are located in the porta hepatis and course through central abdominal structures 4, 5.

  • The hepatic veins are intrahepatic structures that drain into the central inferior vena cava 5.

  • While the spleen itself is a left upper quadrant organ, the splenic vein courses medially across the midline to join the superior mesenteric vein, forming the portal vein in a central location 1, 2.

Clinical Relevance

Understanding this anatomy is critical for several clinical scenarios:

  • In splenic vein thrombosis (sinistral portal hypertension), the isolated occlusion of the splenic vein can cause gastric varices while the portal vein remains patent, demonstrating their anatomical continuity 4, 6, 7.

  • Cross-sectional imaging with CT or MRI using portal venous phase contrast is necessary to evaluate the confluence of the splenic and superior mesenteric veins forming the portal vein 4, 6.

  • The portal vein, splenic vein, and hepatic veins can all be visualized on ultrasound as part of the hepatic vascular assessment, confirming their proximity within the central abdomen 4, 5.

References

Research

ANATOMICAL VARIATIONS OF PORTAL VENOUS SYSTEM: IMPORTANCE IN SURGICAL CLINIC.

Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery, 2022

Research

Portal Vein Thrombosis After Splenic and Pancreatic Surgery.

Advances in experimental medicine and biology, 2017

Research

Variations in the Formation of Hepatic Portal Vein: A Cadaveric Study.

Journal of Nepal Health Research Council, 2020

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Patent Portal Vein with Varices and RUQ Pain in Portal Vein Stent Patient

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Treatment of Inferior Mesenteric Vein Varix

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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