Mesenteric and renal angiography
Debabrata Mukherjee, Eric R. Bates, Marco Roffi, Richard A. Lange, David J. Moliterno, Nadia M. Whitehead in Cardiovascular Catheterization and Intervention, 2017
The SMA usually originates 1 cm lower than the celiac trunk and anterior to the L1 vertebral body.[1] The SMA travels inferiorly and slightly rightward to supply the duodenum and pancreas. In its course, the SMA passes beneath the pancreas and divides into the inferior pancreaticoduodenal, middle colic, right colic, ileocolic, and intestinal branches (Figure 24.2). In general, the middle colic artery provides blood supply to the proximal and midtransverse colon. In some individuals, the middle colic may provide the main source of blood to the splenic flexure. The right colic artery provides the blood supply to the middle and distal ascending colon, while the ileocolic artery supplies the distal ileum, cecum, and proximal ascending colon. The middle, right, and ileocecal branches join together with the left colic artery (from the inferior mesenteric) forming the marginal artery or artery of Drummond that courses along the inside border of the colon. Multiple anatomic variations of the colic arteries exist.
Gastrointestinal surgery in gynecologic oncology
J. Richard Smith, Giuseppe Del Priore, Robert L. Coleman, John M. Monaghan in An Atlas of Gynecologic Oncology, 2018
The blood supply to the colon and rectum is derived from branches of the superior mesenteric, inferior mesenteric, and internal iliac arteries. The right colon is supplied by the SMA through the ileocolic artery, the right colic artery, and a branch of the middle colic artery. The transverse colon is chiefly supplied by the middle colic artery, but there is a communication with the inferior mesenteric arterial system via the marginal artery of Drummond. The inferior mesenteric artery supplies the colon from the splenic flexure to the proximal rectum. The inferior mesenteric artery branches into the left colic artery, the superior rectal artery, and the sigmoid arteries. The distal rectum receives its blood supply from the paired middle and inferior rectal arteries which originate from the internal iliac artery system (Figure 29.10).
Management of Acute Intestinal Ischaemia
Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams in Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
The SMA branches from the aorta just distal to the take-off of the coeliac artery, typically at the level of the L1 vertebral body. It then runs inferiorly, coursing initially posterior to the body of the pancreas. There are multiple branches of the SMA, which supply blood to the duodenum, pancreas, jejunum, ileum and proximal colon. The first of these branches is the inferior pancreaticoduodenal artery, as described above, followed by the middle colic artery, which supplies the transverse colon. The middle colic artery often divides into a right branch and left branch, such that the right branch will supply the proximal transverse colon and the left branch will supply the distal transverse colon. The SMA then gives off multiple (four to six) jejunal branches before (typically) giving off the right colic artery. Finally, the SMA gives off multiple (9 to 13) ileal branches and terminates as a large ileocolic artery that supplies the terminal ileum, caecum and ascending colon. The jejunal and ileal branches divide further after arising from the SMA and form a rich network of arcades within the mesentery by anastomosing with neighbouring branches. These arcades become more numerous and complex towards the ileum. This network of arcades forms the marginal artery of Dwight, which runs parallel to the small intestine and allows for communication amongst the jejunal and ileal branches.
Does transverse colon cancer spread to the extramesocolic lymph node stations?
Published in Acta Chirurgica Belgica, 2021
Bulent C. Yuksel, Sadettin ER, Erdinç Çetinkaya, Ahmet Keşşaf Aşlar
In cases of splenic flexure tumors, extended left colon resection was undertaken. The distal 2/3 of the transverse colon and left colon was performed in accordance with CME and CVL. During CME and CVL, ligation was performed at the point where the left colic artery branches off the inferior mesenteric artery along the aortic border and at the exit point of the left middle colic artery. The left-GEOM region covering the gastrocolic ligaman and omentum was dissected along a vertical line drawn from the transverse colon into the stomach from at least 10 cm proximal of the tumor and included in the specimen together with the infrapancreatic lymph nodes and the distal part of the anterior pancreas peritoneum. The right branch of the middle colic artery was preserved. Anastomosis was undertaken between the transverse and sigmoid colon.
Management of life-threatening hemoperitoneum with minimally invasive percutaneous superselective arterial embolization
Published in Baylor University Medical Center Proceedings, 2021
Gaurav Synghal, Kenneth Ford IV, Kenneth Ford III, Clayton Trimmer
Visceral artery aneurysm and visceral artery pseudoaneurysm are rare, with an estimated incidence of 0.01% to 0.2% in autopsies,7 but they can be life-threatening emergencies with reported mortality between 21% and 100% when ruptured.8 True visceral artery aneurysms are thought to be related to atherosclerosis, while pseudoaneurysms are thought to be most frequently related to trauma/postsurgery or pancreatitis.9 The most affected visceral arteries are splenic (60%) and hepatic arteries (20%).7 Superior mesenteric artery aneurysms or pseudoaneurysms are rarer, representing <6% of visceral artery aneurysms.7 In our case, we found active bleeding from a pseudoaneurysm off the middle colic artery, a branch of the superior mesenteric artery. Due to lack of trauma/surgical history, prior pancreatitis is thought to be the most likely cause in our patient.
Stool dynamics after extrinsic nerve injury during right colectomy with extended D3-mesenterectomy
Published in Scandinavian Journal of Gastroenterology, 2021
Yngve Thorsen, Bojan V. Stimec, Jonas Christoffer Lindstrom, Tom Oresland, Dejan Ignjatovic
The surgical procedure differs in the central lymphadenectomy and has previously been described [3,7,8]. The plane for the central dissection is between the superior mesenteric vessels and their sheaths. All tissue anterior and posterior to the superior mesenteric vessels from 5 mm proximal to the middle colic artery origin to 10 mm distal to the ileocolic artery origin is removed. The medial border follows the left border of SMA (Figure 1).
Related Knowledge Centers
- Ascending Colon
- Pancreas
- Superior Mesenteric Artery
- Transverse Colon
- Abdomen
- Artery
- Left Colic Artery
- Right Colic Artery
- Marginal Artery of The Colon
- Colectomy