This diagnostic visual includes a B-mode grayscale ultrasound image and a corresponding labeled line diagram illustrating a portal vein trifurcation, an anatomical variant of the liver. The image demonstrates the main portal vein (MPV) dividing simultaneously at a single point into three branches: the left portal vein (LPV), the right anterior portal vein (RAPV), and the right posterior portal vein (RPPV), indicating the absence of a common right portal vein trunk. The vascular structures exhibit characteristic hyperechoic walls due to Glisson's capsule and are surrounded by homogeneous, medium-echogenicity liver parenchyma. Posterior and inferior to the portal confluence, the inferior vena cava (IVC) is visible as an anechoic oval structure. This content is intended for surgical planning and radiological education, highlighting variations in hilar anatomy crucial for performing segmentectomies or hepatic resections. The labels facilitate identification of segmental portal supply in the context of intraoperative or diagnostic ultrasound.

This composite figure includes contrast-enhanced computed tomography (CECT) scans and a corresponding anatomical diagram illustrating Congenital Absence of the Portal Vein (CAPV) Type II associated with hepatocellular carcinoma (HCC). (a) Axial arterial phase image shows a large, inhomogeneous hyperenhancing mass occupying the right lobe of the liver with a central hypoattenuating area suggestive of necrosis. (b) Axial portal venous phase image demonstrates the mass becoming isoattenuating relative to the liver parenchyma. (c-e) Coronal reconstruction images highlight a portosystemic shunt. Yellow arrows indicate the superior mesenteric vein (SMV) and splenic vein (SpV) joining to form a large shunt that drains directly into the left renal vein (LRV). (f) A schematic diagram summarizes the venous anatomy, showing the SMV and SpV bypassing the liver via a shunt to the LRV/IVC, with a hypoplastic portal vein (PV) branching toward the liver, characteristic of CAPV Type II. This case highlights the radiological features of hepatoma in the context of rare congenital vascular anomalies.

This medical illustration consists of two side-by-side comparison diagrams depicting the pathophysiology of sinistral (left-sided) portal hypertension due to splenic vein thrombosis. The diagrams show the hepatobiliary and gastrointestinal venous anatomy, including the liver, stomach, spleen, and pancreas. The left diagram represents normal venous anatomy where the splenic vein (SV), portal vein (PV), superior mesenteric vein (SMV), and inferior mesenteric vein (IMV) are patent with physiological blood flow. The right diagram illustrates the effects of a thrombus within the splenic vein. This obstruction leads to retrograde flow and increased pressure in the collateral venous pathways, specifically causing the development of prominent gastric varices, dilatation of the short gastric veins, coronary vein (CV), and gastroepiploic vein (GEV). Notably, in both the normal and pathological states, the portal vein, SMV, and IMV remain patent, highlighting that the hypertension is localized to the splenic drainage system. Arrows indicate the direction of venous blood flow, shifting toward the gastric wall in the presence of the thrombus.

This diagnostic image consists of an intraoperative ultrasound of the liver (left) paired with an anatomical line diagram (right) illustrating the hepatic hilum in a transverse plane. The ultrasound displays normal liver parenchyma with medium echogenicity and a homogeneous texture. The central focus is the bifurcation of the portal vein and the overlying hepatic artery. Key anatomical structures labeled in the diagram and visible on ultrasound include the right portal vein (RPV) and left portal vein (LPV), which appear as larger, hypoechoic vascular structures. Positioned superficial to the portal bifurcation are the smaller, circular cross-sections of the right hepatic artery (RHA) and left hepatic artery (LHA). Additionally, the right hepatic duct (RHD) is identified as a small anechoic structure adjacent to the RHA. This visual material is used in surgical education to demonstrate the 'Mickey Mouse' sign and the spatial relationships within the hepatoduodenal ligament, essential for identifying segmental anatomy during hepatobiliary procedures.

This medical figure consists of two panels focusing on hepatic portal anatomy and pathology. Panel A is an anatomical diagram illustrating the portal venous system in relation to the liver lobes. It depicts the convergence of the splenic vein (SV) and superior mesenteric vein (SMV) into the main portal vein (PV), which bifurcates into the right hepatic lobe (RHL) branches—specifically the right anterior (RAPV) and right posterior (RPPV) portal veins—and the left hepatic lobe (LHL) branches, including the left medial (LMPV) and left lateral (LLPV) portal veins. Panel B is a contrast-enhanced axial abdominal CT scan of a patient with a history of hepatocellular carcinoma (HCC). A blue arrow indicates a widely patent portal vein with uniform contrast opacification, showing no evidence of tumor thrombus at this baseline. The liver parenchyma exhibits a heterogeneous, coarse texture consistent with cirrhotic changes. This comparison serves as an educational reference for normal portal venous flow prior to the development of macrovascular invasion or tumor thrombosis.

This composite educational graphic illustrates the technique for intraoperative ultrasound (IOUS) of the right portal vein. Panel (a) contains an anatomical diagram showing a T-style ultrasound probe placed on the surface of the liver. Numbered arrows (1-3) demonstrate the systematic scanning maneuvers (sliding and rolling) used to visualize the segmental branches of the right portal vein. Panel (b) correlates a specific probe placement over the right liver with a corresponding transverse ultrasound image and its labeled schematic. The ultrasound clearly identifies the right portal vein (RPV) and the right hepatic artery (RHA). The RHA is seen as a smaller tubular structure positioned inferior and slightly anterior to the RPV. The image highlights the use of hyperechoic portal vein walls and proximity to the hepatic hilum to define segmental anatomy. This visual serves as a procedural guide for surgeons to perform complete parenchymal and vascular exploration during hepatobiliary surgery.

This clinical surgical photograph and accompanying schematic illustrate the methodology for regional ischemic preconditioning (RIP) during liver resection. The primary image shows a dissected porta hepatis (PH) with major hilar structures isolated. White rubber vessel loops (tourniquets) are preset around the Right Hepatic Artery (RHA), the Right Portal Vein (RPV), the Common Bile Duct (CBD), and the Left Hepatic Artery/Left Portal Vein (LHA/LPV) complex. This setup allows for selective hemi-hepatic vascular inflow occlusion. Below the photograph, a comparative timeline diagram defines two experimental protocols: the Hemi-Hepatic Vascular (HHV) inflow occlusion group, involving continuous ischemia followed by reperfusion, and the RIP group, which precedes the main ischemic event with a brief 5-minute occlusion and 5-minute reperfusion cycle. The educational focus is on the anatomical identification of the hepatic pedicle branches and the surgical technique for inducing controlled, temporary regional ischemia to mitigate reperfusion injury.