Venous Drainage

Proximal Third

The inferior thyroid, and intercostal bronchial, in general drain the upper esophagus.  In the neck the final common pathway of cervical esophageal venous drainage is via the brachiocephalic vein.  Tributaries drain into the inferior thyroid vein which empties into the right brachiocephalic and/or left brachiocephalic vein.

The Middle Third

In the chest the final common pathway of thoracic esophageal venous drainage is via the azygos or brachiocephalic on the right or the hemiazygos, accessory hemiazygos, or brachiocephalic vein on the left.

Distal Third

In the lower third and abdomen the final common pathway of lower esophageal venous drainage is via the portal vein or splenic vein.  Tributaries from the short abdominal esophagus drain mostly into the left gastric (coronary) vein but also into short gastric veins (and thereby also the splenic and left gastro-epiploic veins).


Esophagus – venous drainage

32341 tube colon small bowel lung bronchus bronchi esophagus stomach large bowel bile duct ureter tube principles blood supply venous drainage artery vein lymphatic drainage lymphatics Courtesy Ashley DAvidoff MD Davidoff art mucosa submucosa muscularis adventitia serosa histology

Abdominal esophagus – venous drainage
Courtesy Ashley Davidoff MD 01217 code esophagus + vein + ;liver portal vein spleen splenic vein left gastric vein coronary vein IMV inferior mesenteric vein fx short gastric varices + angiography transhepatic venogram anatomy

Venous drainage begins in a submucosal venous plexus piercing the muscle layers.  Another venous plexus is formed on the external surface of the esophagus.

Esophagus – venous lakes
Courtesy Ashley Davidoff MD 01198 esophagus + vein + venous lake imaging endoscopy

GE varices

Courtesy Ashley Davidoff MD 16833 code esophagus vein + gastroesophageal varices dx cirrhosis + imaging radiology CTscan

Esophageal varices
code esophagus vein varix varices GIT CVS portal hypertension liver 35041c