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Splenic vein

The splenic vein is a major component of the portal venous system, responsible for draining blood from the spleen, pancreas, stomach, and portions of the omentum. It forms at the splenic hilum by the union of small venules, then courses horizontally along the posterior surface of the pancreas, and joins the superior mesenteric vein (SMV) posterior to the neck of the pancreas to form the portal vein.

The splenic vein lies posterior to the pancreas, anterior to the left kidney, and inferior to the splenic artery. Along its course, it receives several tributaries including the short gastric veins, left gastroepiploic vein, pancreatic veins, and inferior mesenteric vein (IMV). In many cases, the IMV joins the splenic vein before its confluence with the SMV.

Clinically, the splenic vein is significant in portal hypertension, splenic vein thrombosis, pancreatitis-related vascular complications, and surgical planning. Splenic vein thrombosis can lead to left-sided portal hypertension and isolated gastric varices.

Synonyms

  • Vena splenica

  • Lienal vein

Function

  • Collects deoxygenated, nutrient-rich blood from the spleen, pancreas, and stomach

  • Forms the portal vein in conjunction with the SMV

  • Provides a major route of venous return for upper abdominal viscera

  • Plays a key role in portal hypertension and variceal formation

Tributaries

  • Short gastric veins

  • Left gastroepiploic vein

  • Pancreatic veins

  • Inferior mesenteric vein (commonly)

MRI Appearance

T1-weighted images:

  • Splenic vein appears as a tubular signal void (black lumen) coursing posterior to the pancreas

  • Surrounded by retroperitoneal fat planes that provide contrast

T2-weighted images:

  • Normal venous flow appears as a signal void

  • Thrombosis or slow flow may appear as intermediate to hyperintense signal

STIR:

  • Fat suppression improves visualization against retroperitoneal and peripancreatic fat

  • Perivascular inflammation or edema shows hyperintensity

T1 Post-Gadolinium (Gd-enhanced MRI):

  • Splenic vein lumen enhances brightly and homogeneously with contrast

  • Filling defects indicate thrombosis, tumor thrombus, or stenosis

  • Essential for evaluating portal venous anatomy and collateral circulation

MRA (Magnetic Resonance Angiography):

  • Contrast-enhanced MRA provides 3D visualization of splenic vein origin, tributaries, and confluence with SMV

  • Detects stenosis, occlusion, collateral pathways, or congenital variants

CT Appearance

Non-contrast CT:

  • Appears as a tubular soft-tissue density posterior to the pancreas

  • Limited for vessel assessment unless calcification or thrombus present

CT Post-Contrast (CT Venography / CECT):

  • Splenic vein opacifies with contrast, showing its origin at the splenic hilum, pancreatic course, and confluence with SMV

  • Multiplanar and 3D reconstructions highlight tributaries and anatomical variations

  • Detects splenic vein thrombosis, extrinsic compression, tumor invasion (e.g., pancreatic carcinoma), varices, and collateral circulation

CT images

Splenic vein anatomy CT axial image -img-00000-00000

CT images

Splenic vein anatimy ct image

MRI image

Splenic vein anatomy MRI axial image -img-00000-00000