Superior mesenteric artery

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Artery: Superior mesenteric artery
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The pancreas and duodenum from behind. (Superior mesenteric artery labeled at upper right.)
Superior mesenteric a.gif
Frontal view of the superior mesenteric artery and its branches. The large vessel (blue) beside the SMA is the superior mesenteric vein. A considerable number of different branching patterns exist.
Latin arteria mesenterica superior
Gray's subject #154 606
Supplies intestine
Source abdominal aorta   
Branches inferior pancreaticoduodenal
middle colic
right colic
intestinal branches (jejunal, ileal)
ileocolic
Vein superior mesenteric vein
Precursor vitelline arteries
MeSH Mesenteric+Artery,+Superior
Dorlands
/ Elsevier
    
a_61/12155072

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]



In human anatomy, the superior mesenteric artery (SMA) arises from the anterior surface of the abdominal aorta, just inferior to the origin of the celiac trunk, and supplies the intestine from the lower part of the duodenum to the left colic flexure and the pancreas.

Location and path

It arises anterior to vertebra L1 in an adult. It is usually 1cm lower than the celiac trunk. It initially travels in an anterior/inferior direction, passing behind/under the neck of the pancreas and the splenic vein. Located under this portion of the superior mesenteric artery, between it and the aorta, are the following:

The SMA typically runs to the left of the similarly named vein, the superior mesenteric vein. After passing the neck of the pancreas it starts giving off its branches.

Branches

Branch Supplies
inferior pancreaticoduodenal artery head of the pancreas and to the descending and inferior parts of the duodenum
middle colic artery to the transverse colon
right colic artery to ascending colon
intestinal arteries branches to ileum, branches to jejunum
ileocolic artery (terminal branch of the SMA) supplies last part of ileum, cecum, and appendix

The middle, right, and ileocecal branches anastomose with each other to form a marginal artery along the inner border of the colon. This artery is completed by branches of the left colic which is a branch of the inferior mesenteric artery.

Pathology

  • Compared to other vessels of similar size, the SMA is largely spared the effects of atherosclerosis. This is likely due to protective haemodynamic conditions
  • Occlusion of the SMA almost invariably leads to intestinal ischemia and often has devastating consequences; up to 80% of SMA occlusions lead to death.[1]
  • The SMA can compress the left renal vein, leading to the nutcracker syndrome and/or the third (horizontal) part of the duodenum, leading to SMA syndrome.

Additional images

References

  1. Redaelli CA, Schilling MK, Buchler MW. Intraoperative laser Doppler flowmetry: a predictor of ischemic injury in acute mesenteric infarction. Dig Surg. 1998;15(1):55-9. PMID 9845564. Full Text.

External links


de:Arteria mesenterica superior


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