mesenteric vessel anatomy

celiac axis (CA)

• anterior branch of the aorta

• superior to the body of the pancreas

normal length of the CA:

1-3 cm

the CA splits into what vessels?

• common hepatic A

• L gastric A

• splenic A

what are some anatomic variants of the CA?

• CA and SMA may share a common trunk

• HA may originate from the SMA

• HA may originate directly from the aorta

what are the branches of the CA?

• left gastric A (LGA)

• common hepatic A (CHA)

• splenic A (SA)

left gastric artery (LGA)

• smallest branch of the CA

• travels anterior and cephalad supplies stomach and pylorus

• not usually seen sonographically

common hepatic artery (CHA)

• right branch of the CA

• supplies blood to the liver, GB and stomach

the CHA branches into what vessles?

• proper hepatic A which enters the liver

• gastroduodenal A which supplies the pancreas and duodenum

anatomic variants of the CHA include:

• HA originates from SMA → most common

• HA originates from the aorta

splenic artery (SA)

• largest branch of the CA

• tortuous course posterior to the body and prox tail of the pancreas

• most tortuous artery in the body

• supplies blood to the spleen, pancreas and fundus of the stomach

• most common site of aneurysm of a visceral vessel → most common in females

superior mesenteric artery (SMA)

• anterior branch of the aorta

• runs parallel to the aorta posterior to the body of the pancreas

• supplies blood to the jejunum, ileum, cecum, ascending colon, prox 2/3 transverse colon, duodenum and pancreatic head

• communicates with the CA via the pancreaticduodenal arcade

• terminates near the ileocecal valve

intestines need continuous flow while digestion occurs, what can occur if stenosis is present in the SMA?

intestinal angina

inferior mesenteric artery (IMA)

• originates 3-4 cm above the aortic bif, on the left anterolateral aspect of the aorta and courses inferiorly to the left

• provides blood supply tot he distal colon and prox rectum

the SMA communicates with the IMA through:

the arc of Riolan and the marginal artery of Drummond

arc of Riolan and marginal artery of Drummond:

provide the potential for collateral flow with mesenteric arterial obstruction

the IMA dilates due to compensatory flow related to:

an SMA stenosis