Coeliac Trunk, Superior and Inferior

Mesenteric Arteries
By
Dr. A.U. Agu
MBBS, MSc, PhD
POWERED BY NWONU
CHUKWUNONSO (Nonski)
11/16/2021 1
 Introduction
• The 3 anterior branches of
abdominal aorta are;
– Coeliac trunk
– Superior mesenteric a (SMA)
– Inferior mesenteric a (IMA)
• They are the arteries of
foregut, midgut & hindgut
respectively
• The branches of these 3
arteries anastomose.
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 THE COELIAC TRUNK
Introduction
The largest of the 3 unpaired
branches of the abdominal
aorta
Arises from the anterior
surface of the aorta at the level
of T12 ( just below the opening
of diaphragm
About 1.25cm & is directed
horizontally.
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Artery of the foregut & supplies all the derivatives of
the foregut the lie in the abdomen, viz:
• Lower end of oesophagus
• Stomach
• Upper part of duodenum (up to the opening of the bile duct)
• Liver
• Spleen
• Greater part of pancreas

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 Relations
• Lies behind the omental bursa & below caudate
lobe of the liver
• It is above the upper part of the pancreas and
splenic vein
• Surrounded by coeliac plexus of nerve

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 Branches
3 branches
– Left gastric a.
– Splenic a.
– Common hepatic a.

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 Left Gastric Artery
• Smallest of the 3 branches
• Passes upwards & to the left
towards the stomach.
• Then turns forward to enter the
lesser omentum
• Supplies the stomach
• Gives 2 or 3 oesphageal branches
• Many gastric branches along the
lesser curvature
• Anastomoses with the right gastric
artery
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 Splenic artery
• The largest branch
• Has a tortuous course along the upper border of the
pancreas
• Divide into 5 or more branches that enter the hilus

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Other branches are
• Many pancreatic branches, largest of which is arteria
pancreatica magna.
– A large branch to the tail is arteria caudea pancreatis
• 5-7 short gastric arteries – from end of splenic a &
supplies the stomach fundus
• Left gastroepiploic artery – from end of splenic a &
anastomoses with right gastroepiploic artery

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 Common hepatic artery
• Arises as common hepatic
artery
• Runs downwards, forward & to
the right.
• Ascends b/w the 2 layers of
lesser omentum
• At the porta hepatics, it divides
into right & left hepatic arteries

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 Branches
Supraduodenal a.
Gastroduodenal artery –
arises at upper border of 1st
part of duodenum (point
where common hepatic
became proper hepatic).
It divides into
– Right gastroepiploic a. –
which anastomoses with
gastroepiploic a

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 – Superior pancreaticoduodenal a (anterior & posterior) -
anastomoses with inferior pancreaticoduodenal a
Right gastric a. – from proper hepatic a &
anastomoses withleft gastric a
Cystic a – from right hepatic a, divides into
superficial & deep branches

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 Variations
• Coeliac trunk may give off one or both of the inferior
phrenic arteries.
• SMA may arise with CA as common origin.

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 Superior Mesenteric Artery
• Arises at the level of L1, 1cm below coeliac a & behind the
body of pancreas
• Runs downwards & to the right
• Terminates in the iliac fossa by anastomosing with ileocolic a

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• Supplies all the derivatives of midgut, viz
– Lower part of duodenum
– Jejunum
– Ilium
– Appendix
– Caecum
– Ascending colon
– Right 2/3 of T- colon
– Lower ½ of head of pancreas

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Relations
• Anteriorly - body of pancreas & splenic vessels
• Posteriorly - aorta, left renal vein, uncinate process
& 3rd part of duodenum
• It crosses the IVC & rt psoas
• Accompanied by SMV

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Branches
• From the right side
– Inferior
pancreaticoduodenal –
arises at the level of 3rd part
of duodenum, divides into
ant & post branches & ends
by anastomosing with
superior
pancreaticoduodenal
– Middle colic – divides into rt
& Lt which anastomose with
rt & Lt colic respectively
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 – Right colic - divides into descending & ascending
branche that anastomose with ileocolic & middle colic
respectively
– Ileocolic - divides into superior & inferior branches that
anastomose withrt colic a & termination of IMA
respectively

• From the leftt side

– 12-15 jejunal
– Ileal

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 Inferior mesenteric artery
• Arises behind the 3rd part
of duodenum, at the level
of L3 & 4-5cm above the
bifurcation of the aorta
• Runs downward & to the
left, behind he peritoneum
• Continues in the sigmoid
colon as the superior rectal
artery

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Supplies the following structures;
• Left 1/3 of the transverse colon
• Descending colon
• Sigmoid colon

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Branches
• Left colic a – 1st branch, runs
upwards & to left
– Divides into ascending &
descending branches that
anastomose with middle colic &
highest sigmoid artery respectively
• 2-4 Sigmoid a – run down & to
the left & anastomose with each
other to form the lower part of
marginal artery
• Superior rectal a – a continuation
of IMA
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Marginal artery of drummond
• Arterial arcade located at
the concavity of the colon
• Formed by anastomoses
b/w Ileocolic, Rt
colic,middle colic, Lt colic &
sigmoid arteries
• Lies 2.5cm-3.8cm from the
colon

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 THANKS
FOR
LISTENING

POWERED BY NWONU
CHUKWUNONSO (Nonski)

11/16/2021 Good luck...🌟 24