Hepatic veins

Anatomy and course 

The hepatic veins arise within the liver parenchyma from the small central veins that drain the liver sinusoids. The left, intermediate and right hepatic veins then course between the four sectors of the liver, demarcating their boundaries; 

• The left hepatic vein courses between the left lateral and left medial sectors, which compose the left lobe of the liver.
• The right hepatic vein courses between the right medial and right lateral sectors, which compose the right lobe of the liver. 
• The intermediate hepatic vein lies between the right and left lobes of the liver.

The course of the hepatic veins provides additional anatomical landmarks to further divide the four sectors of the liver (left lateral, left medial, right lateral, right medial) into eight segments, numbered by Roman numerals I-VIII. 

Right hepatic vein

The right hepatic vein is the longest of the hepatic veins, formed anteriorly near the inferior border of the liver. It runs in the coronal plane through the right portal fissure, between the right medial and right lateral sectors of the liver. 

The vertical plane that passes through the right hepatic vein demarcates the border between the segments VI and VII, which are posterior to this plane, and segments V and VIII which are anterior to this plane. The right hepatic vein drains the segments VI and VII, and occasionally parts of segments V and VIII.

The vein terminates by draining into the inferior vena cava near the upper border of the caudate lobe of the liver, just below the central tendon of the diaphragm.

Intermediate hepatic vein

The intermediate hepatic vein, also referred to as the middle hepatic vein, runs in the middle hepatic fissure, between the right and left lobes of the liver. The vertical plane that passs through the intermediate hepatic vein defines the border between the segments V and VIII that lie posterolaterally to the plane, and segments IVa and IVb that lie anteromedially to the plane. 

The intermediate hepatic vein drains the central part of the liver and receives tributaries from segments IV, V and VIII. Occasionally, the intermediate hepatic vein establishes intrahepatic venous anastomoses with the right hepatic vein.

The intermediate hepatic vein usually joins the left hepatic vein and forms a short common trunk before draining into the inferior vena cava. Only in about 10% it drains directly into the inferior vena cava.

Left hepatic vein

The left hepatic vein runs between the left medial and left lateral sectors of the liver, lying partially in the fissure for the ligamentum teres and partially in the left hepatic fissure. The vertical plane that passes through the left hepatic vein demarcates the border between the segments IVa and IVb anteriorly, and segments II and III posteriorly. 

The left hepatic vein drains segments II, III, and occasionally the segment IV. Along its course, the left hepatic vein receives its major tributary, the umbilical vein, which lies within the umbilical fissure.

The left hepatic vein terminates by draining into the inferior vena cava, most often via a common trunk that forms with the intermediate hepatic vein.

The hepatic veins drain the liver, which is an accessory digestive organ. Learn more about the remaining digestive organs in an easy and efficient way using Kenhub's digestive system quizzes and free learning tools.

Veins of the caudate lobe

The veins of the caudate lobe are highly inconsistent, varying in number from one to five. When present, they drain the segment I of the liver that corresponds to the caudate lobe. The veins of the caudate lobe terminate by draining directly into the inferior vena cava.

Learn more about the hepatic veins and test your knowledge using the following study unit: