Ultrasound anatomy of the left gastric vein

A study of 187 consecutive patients undergoing upper abdominal ultrasound was conducted to evaluate the size and the ending of the left gastric vein (LGV) into the portal system and its relation to the coeliac axis and tributaries. The LGV was identified in 86 (46%) of these patients; the mean size of the LGV was 2.4 mm, 30% terminating in the portal vein, 33% at the splenoportal junction and 37% in the splenic vein. The LGV was anterior to the coeliac trunk and its branches in 45%, two thirds of these ending in the splenic vein and posterior in 51% of the cases, 86.3% of which ended at or to the right of the splenoportal junction. In conclusion, the variation in the site of termination of the LGV has a significant correlation with the course of the LGV in relation to the adjacent vessels. The LGV tends to cross superficial to the splenic artery when it enters the splenic vein and deep to the common hepatic artery when draining in the portal vein.