ARTERIAL SUPPLY OF MIDGUT & HINDGUT

Dr. Ahmed Fathalla Ibrahim

SUPERIOR MESENTERIC SUPERIOR MESENTERIC ARTERYARTERY

ILEOCOLIC ARTERYILEOCOLIC ARTERY


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


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


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)


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


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


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


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


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


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


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

ARTERIAL SUPPLY OF MIDGUT & HINDGUT

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