ARTERIAL SUPPLY OF MIDGUT & HINDGUT

Dr. Ahmed Fathalla Ibrahim

SUPERIOR MESENTERIC SUPERIOR MESENTERIC ARTERYARTERY

SUPERIOR MESENTERIC SUPERIOR MESENTERIC ARTERYARTERY

SUPERIOR MESENTERIC SUPERIOR MESENTERIC ARTERYARTERY

SUPERIOR MESENTERIC SUPERIOR MESENTERIC ARTERYARTERY

SUPERIOR MESENTERIC SUPERIOR MESENTERIC ARTERYARTERY

ILEOCOLIC ARTERYILEOCOLIC ARTERY

SUPERIOR MESENTERIC SUPERIOR MESENTERIC ARTERYARTERY

SUPPLY: SUPPLY: • It is the artery of midgutartery of midgut• It supplies: 1. Duodenum: 2nd part (below biliary

orifice), 3rd & 4th parts2. Jejunum & ileum3. Cecum & appendix4. Ascending colon5. Right 2/3 of transverse colon

SUPERIOR MESENTERIC SUPERIOR MESENTERIC ARTERYARTERY

ORIGIN:ORIGIN:• It arises as a single brancha single branch from the

front of abdominal aortafront of abdominal aorta

• It lies at the level of lower border of L1level of lower border of L1

• Its origin lies behind body of pancreasbehind body of pancreas

SUPERIOR MESENTERIC SUPERIOR MESENTERIC ARTERYARTERY

COURSE:COURSE:• It descends describing a curve with a a curve with a

concavity towards the rightconcavity towards the right• It runs through the root of mesentery through the root of mesentery

of small intestineof small intestine

TERMINATION:TERMINATION:• It ends by anastomosing with the ileal anastomosing with the ileal

branches of ileocolic arterybranches of ileocolic artery (its own branch)

SUPERIOR MESENTERIC SUPERIOR MESENTERIC ARTERYARTERY

RELATIONS:RELATIONS:• The artery descends anterior to (crosses)descends anterior to (crosses) the

following structures:1.Left renal vein2.Uncinate process of pancreas3.Third part of duodenum4.Abdominal aorta5. Inferior vena cava6.Right psoas major muscle (+ right ureter)• On its right side (lateral to it): On its right side (lateral to it): superior

mesenteric vein

BRANCHES OF SUPERIOR BRANCHES OF SUPERIOR MESENTERIC ARTERYMESENTERIC ARTERY

Inferior pancreaticoduodenal artery: Inferior pancreaticoduodenal artery: • Runs (as a single or double branches)

in the groove between head of between head of pancreas & duodenumpancreas & duodenum

• Supplies head of pancreas & head of pancreas & duodenumduodenum

• Ends by anastomosing withanastomosing with superior pancreaticoduodenal artery

BRANCHES OF SUPERIOR BRANCHES OF SUPERIOR MESENTERIC ARTERYMESENTERIC ARTERY

Jejunal & ileal branches:Jejunal & ileal branches:• They are 12 to 15 in number• They arise from the left side of arteryfrom the left side of artery• They run between the 2 layers of mesentery of between the 2 layers of mesentery of

small intestinesmall intestine• Each artery divides into 2 branches which

anastomose with adjacent branches forming arcadesarcades. Branches of arcades unite to form 2nd, 3rd & 4th series of arcades. Terminal arcades gives straight end arteries supplying jejunum & ileumstraight end arteries supplying jejunum & ileum

• Fewer arcades supply jejunumFewer arcades supply jejunum compared to ileum

BRANCHES OF SUPERIOR BRANCHES OF SUPERIOR MESENTERIC ARTERYMESENTERIC ARTERY

Ileocolic artery:Ileocolic artery:• Arise from the right side of arteryfrom the right side of artery• Descends downward & to the right (anterior to right downward & to the right (anterior to right

psoas major muscle)psoas major muscle)• Divides into:1.1. Superior branch:Superior branch: supplies lower part of ascending

colon & anastomoses with descending branch of right colic

2.2. Inferior branch:Inferior branch: divides into the following arteries:• Anterior & posterior cecal • Appendicular (may arise from posterior cecal)• Ileal branches: supply distal part of ileum &

anastomose with termination of superior mesenteric artery

BRANCHES OF SUPERIOR BRANCHES OF SUPERIOR MESENTERIC ARTERYMESENTERIC ARTERY

Right colic artery:Right colic artery:• Arise from the right side of arteryfrom the right side of artery• Divides into:1.1. Ascending branch:Ascending branch: anastomoses with

right branch of middle colic artery2.2. Descending branch:Descending branch: anastomoses

with superior branch of ileocolic artery

• Supplies ascending colon & right ascending colon & right colic flexurecolic flexure

BRANCHES OF SUPERIOR BRANCHES OF SUPERIOR MESENTERIC ARTERYMESENTERIC ARTERY

Middle colic artery:Middle colic artery:

• Arise from the right side of arteryfrom the right side of artery

• Divides into:

1.1. Right branch:Right branch: anastomoses with ascending branch of right colic artery

2.2. Left branch:Left branch: anastomoses with ascending branch of left colic artery

• Supplies right 2/3 of transverse colonright 2/3 of transverse colon

INFERIOR MESENTERIC INFERIOR MESENTERIC ARTERYARTERY

SUPPLY: SUPPLY: • It is the artery of hindgutartery of hindgut• It supplies: 1.Left 1/3 of transverse colon2.Descending colon3.Sigmoid colon4.Rectum5.Upper (endodermal) part of anal canal

INFERIOR MESENTERIC INFERIOR MESENTERIC ARTERYARTERY

INFERIOR MESENTERIC INFERIOR MESENTERIC ARTERYARTERY

ORIGIN:ORIGIN:• It arises as a single brancha single branch from the

front of abdominal aortafront of abdominal aorta

• It lies at the level of L3level of L3

• Its origin lies behind 3behind 3rdrd part of part of duodenumduodenum

INFERIOR MESENTERIC INFERIOR MESENTERIC ARTERYARTERY

COURSE & RELATIONS:COURSE & RELATIONS:• The artery descends to the left side of to the left side of

abdominal aortaabdominal aorta• It lies anterior toanterior to left psoas major

muscle & left common iliac artery• On its left side (lateral to it):On its left side (lateral to it): inferior

mesenteric vein• Continues in the pelvis as superior as superior

rectal arteryrectal artery

BRANCHES OF INFERIOR BRANCHES OF INFERIOR MESENTERIC ARTERYMESENTERIC ARTERY

Left colic artery:Left colic artery:• Divides into:

1.1. Ascending branch:Ascending branch: anastomoses with left branch of middle colic artery

2.2. Descending branch:Descending branch: anastomoses with sigmoid arteries

• Supplies: left 1/3 of transverse colon, left 1/3 of transverse colon, left colic flexure & descending colonleft colic flexure & descending colon

BRANCHES OF INFERIOR BRANCHES OF INFERIOR MESENTERIC ARTERYMESENTERIC ARTERY

Sigmoid arteries:Sigmoid arteries:• They are 2 or 3 branches

• They anastomose withanastomose with:

1. Descending branch of left colic artery

2. Superior rectal artery

• They supply: sigmoid colonsigmoid colon

MARGINAL ARTERYMARGINAL ARTERY

MARGINAL ARTERYMARGINAL ARTERY

• It is formed by the anastomosis between the anastomosis between the colic branches of superior & inferior the colic branches of superior & inferior mesenteric arteriesmesenteric arteries

• It beginsbegins by anastomosis between ileal branches of ileocolic & termination of superior mesenteric artery

• It ends ends by anastomosis between sigmoid branches of inferior mesenteric with superior rectal artery

• From the marginal artery, straight end straight end arteries (vasa recta)arteries (vasa recta) supply the large supply the large intestineintestine