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Right gastric vein

The right gastric vein is a small but clinically important vessel that drains blood from the lesser curvature of the stomach. It typically arises near the pyloric region, runs superiorly along the lesser curvature, and empties into the portal vein close to its origin. In some individuals, it may drain into the splenic vein or superior mesenteric vein (SMV) instead.

The right gastric vein communicates extensively with the left gastric vein, forming an anastomotic arcade along the lesser curvature. This venous pathway becomes particularly significant in portal hypertension, as it may serve as a collateral channel contributing to esophageal and gastric varices.

Clinically, the right gastric vein is important in gastric surgery (gastrectomy, vagotomy), portal hypertension evaluation, and interventional procedures. Its identification is also crucial in liver transplantation and TIPS (transjugular intrahepatic portosystemic shunt) procedures, where variations in venous drainage influence surgical outcomes.

Synonyms

  • Coronary vein of the stomach (lesser curvature branch)

  • Right gastroportal vein

Function

  • Drains blood from the lesser curvature of the stomach

  • Empties primarily into the portal vein

  • Provides anastomotic communication with the left gastric vein

  • Contributes to collateral circulation in portal hypertension

MRI Appearance

T1-weighted images:

  • Right gastric vein appears as a thin linear flow void along the lesser curvature

  • Surrounded by intermediate signal stomach wall and high-signal fat planes

T2-weighted images:

  • Vein appears as a dark flow void against higher signal intensity of gastric wall and perivisceral fat

  • Dilatation (in portal hypertension) may be seen as prominent curvilinear hypointense channels

STIR:

  • Fat suppression increases visibility of venous channels near the lesser curvature

  • Associated perivascular edema or inflammation appears bright hyperintense

T1 Fat-Saturated (Pre-contrast):

  • Lumen shows intermediate signal intensity, clearly visible against suppressed fat

  • Useful for differentiating vein from adjacent fat planes

T1 Fat-Saturated Post-Contrast (Gadolinium):

  • Vein enhances homogeneously and brightly in the venous phase

  • Useful in evaluating patency, thrombosis, or variceal communication

MRV (Magnetic Resonance Venography):

  • Depicts the origin, course along lesser curvature, and drainage into portal vein

  • Demonstrates collateral formation and varices in portal hypertension

  • Useful in pre-TIPS evaluation and liver transplant donor work-up

CT Appearance

CT Pre-Contrast:

  • Vein appears as a small tubular soft-tissue density along lesser curvature

  • Difficult to differentiate from adjacent gastric wall without contrast

CT Post-Contrast:

  • Vein enhances strongly during portal venous phase

  • Dilated veins along lesser curvature are evident in portal hypertension

CTV (CT Venography):

  • Gold standard for detailed visualization of gastric venous anatomy

  • Shows origin near pylorus, course along lesser curvature, and confluence with portal vein

  • 3D reconstructions highlight venous collaterals, varices, or thrombosis

  • Essential for surgical planning, portal hypertension assessment, and interventional radiology procedures

MRI images

Right gastric vein MRI coronal anatomy image -img-00000-00000

CT images

Right gastric vein CT axial image 1

CT images

Right gastric vein CT axial image 2

CT images

Right gastric vein CT axial image 3