The colon, the part of the large intestine, usually receives its arterial blood supply from branches of the superior and inferior mesenteric arteries. Hemorrhoids occur when the submucosal venous plexus (hemorrhoidal) are over dilated. VII. The descending left colic artery travels inferolaterally to anastomose with the highest sigmoid artery. Lymphatics of the Colon: With Special Reference to the Operative Treatment of Cancer of the Colon. Google Scholar, Carlson BM (2009) Human embryology and developmental biology. 2020 The T10-L2 thoracolumbar outflow of sympathetic fibers are responsible for the inhibitory activity along the large intestines. Because the preliminary symptoms typically resolve by themselves, prompt surgical management is not always required. The first branch ran transversally to the left to supply the proximal part of the descending colon. Branches from the SMA included the inferior pancreaticoduodenal, right colic, ileocolic, jejunal and ileal arteries. The middle colic artery is the second to leave the superior mesenteric artery. The variant blood supply to the descending colon, rectosigmoid and rectum based on 400 dissections. https://doi.org/10.1007/s00276-019-02245-4, DOI: https://doi.org/10.1007/s00276-019-02245-4, Over 10 million scientific documents at your fingertips, Not logged in The large intestine is a part of the midgut (from the ileocecal junction, the cecum and vermiform appendix to the proximal two-thirds of the transverse colon) and the hindgut (from the distal ⅓ of the transverse colon to the sigmoid colon). Vast networks of anastomosing blood vessels supply the tract. The cause of death in the donor was indicated as myocardial infarction. The CA had a normal branching pattern (Fig. Schematic drawing of the case showing variant middle mesenteric artery originating directly from the anterior surface of the abdominal aorta between the origins of the superior and inferior mesenteric arteries. The parasympathetic fibers are responsible for increasing secretomotor activity along this segment of the digestive tract. branches of inferior mesenteric artery. Last reviewed: August 31, 2020. PubMed Google Scholar. Subsequent to the ischemia, necrosis of the affected sections is likely. The left colic artery that usually takes its origin from the IMA was also missing. SMP & MAPS' stands for: In the mucosa of the large intestines, isolated aggregates of lymphatic tissue are distributed along its length as a first line of filtration. Box 2240, Moshi, Tanzania, Radiology Program in Anatomy, Weill Cornell Medicine, New York, NY, 10065, USA, You can also search for this author in In the surgical treatment of invasive colonic malignancies, for example, resection of the involved colon is usually accompanied with ligature of the accompanying arterial branches [1, 6]. Learning anatomy is a massive undertaking, and we're here to help you pass with flying colours. Last's Anatomy, 12th Edition, Edinburgh: Churchill Livingstone/Elsevier, Page 244-7, 255-8. The sigmoid arteries are a series of about four loops of vessels resting in the sigmoid mesocolon that anastomose with each other; the last of which anastomoses with the superior rectal artery. - 91.211.115.41. The pattern of blood supply to the colon has implications on the surgical techniques and treatment outcomes on various pathological conditions involving the colon. Hansen, J., & Netter, F. (2014). From its origin on the abdominal aorta, the variant artery ran obliquely superiorly toward the left colic flexure. PubMed Central  Springer, New York, pp 9–23, Koizumi J, d’Othee BJ, Otal P, Otal P, Rousseau H, Joffre F, Kohda E, Hiramatsu K (1999) Middle mesenteric artery visualized by computed tomographic angiography. Our engaging videos, interactive quizzes, in-depth articles and HD atlas are here to get you top results faster. The ascending and descending branches of the left colic artery arise after a relatively short superolateral course. It should be noted that above the point of entry of the splenic vein, the vessel is referred to as the hepatic portal vein. The celiac artery and the superior mesenteric artery originated independently from the ventral surface of the abdominal aorta about 1 cm apart (Fig. Anat Rec 145:171–173, CAS  Anatomical variation in this classical arrangement has been reported [4, 7]. Extrinsic innervation is received primarily by both the parasympathetic and sympathetic divisions of the autonomic nervous system. Resection of the colon is based on the arterial supply to its various anatomic divisions (see the image below). The ascension of the left colic artery, a branch from IMA, to the left colic flexure has been reported to be limited in some cases, threatening the anastomosis of the marginal artery in this region [4]. Sinnatamby, C., & Last, R. (2011). The variations in the vascular supply of the small and large intestines can best be understood by appreciating the early development of the small and large intestines and their vascular supply. The right colic artery typically arises independently from the superior mesenteric artery; but it may also be given off with the ileocolic artery. 2). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The inferior mesenteric vein travels superiorly, then medially, eventually draining into the splenic vein posterior to the pancreas. These marginal arteries give off arteriae rectae (straight arteries) which supplies the colon directly. 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