Arterial supply of the intestine

The alimentary tract develops from the fore-, mid- and hind-gut; the arterial supply to each is discrete, although anastomosing with its neighbour. The fore-gut comprises stomach and duodenum as far as the entry of the bile duct and is supplied by branches of the coeliac axis which arises from the aorta at T12 vertebral level (see Fig. 53). The mid-gut extends from mid-duodenum to the distal transverse colon and is supplied by the superior mesenteric artery (Fig. 66) arising from the aorta at L1. Its branches are:

1 the inferior pancreaticoduodenal artery;

2 jejunal and ileal branches—supplying the bulk of the small intestine;

3 the ileocolic artery, supplying terminal ileum, caecum and commencement of ascending colon and giving off an appendicular branch to the appendix—the most commonly ligated intra-abdominal artery;

4 the right colic artery—supplying the ascending colon;

5 the middle colic artery—supplying the transverse colon.

The hind-gut receives its supply from the inferior mesenteric artery (Fig. 66), arising from the aorta at L3 and giving the following branches:

1 the left colic artery—supplying the descending colon;

2 the sigmoid branches—supplying the sigmoid;

3 the superior rectal artery—supplying the rectum.

Each branch of the superior and inferior mesenteric artery anastomoses

Inferior Mesenteric Artery Anatomy
Fig. 66 The superior and inferior mesenteric arteries and their branches.

Right and left hepatic veins draining into inferior vena cava

Superior And Inferior Mesenteric Veins

Superior-Inferior mesenteric veins

Fig. 67 The composition of the portal system.

Superior-Inferior mesenteric veins with its neighbour above and below so that there is, in fact, a continuous vascular arcade along the whole length of the gastrointestinal canal.

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