open access

Vol 81, No 2 (2022)
Original article
Submitted: 2021-01-07
Accepted: 2021-02-22
Published online: 2021-03-22
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Topographic location and branching pattern of the superior mesenteric artery with its clinical relevance: a cadaveric study

S. Nigah1, A. Patra2, S. Chumbar2, P. Chaudhary1
DOI: 10.5603/FM.a2021.0031
·
Pubmed: 33778940
·
Folia Morphol 2022;81(2):372-378.
Affiliations
  1. Department of Anatomy, All India Institute of Medical Sciences, Bathinda (PB), India
  2. Department of Forensic Medicine, GGS Medical College, Faridkot, India

open access

Vol 81, No 2 (2022)
ORIGINAL ARTICLES
Submitted: 2021-01-07
Accepted: 2021-02-22
Published online: 2021-03-22

Abstract

Background: The topographic location of the superior mesenteric artery (SMA) and its branching pattern are usually arbitrary in textbooks. This study, therefore, aims to provide topographic information of SMA with reference to the vertebral bodies, ventral branches of aorta and branching pattern of SMA.
Materials and methods: The study was conducted on 35 embalmed adult human cadavers. We performed detailed dissection of the SMA to topographically locate its origin in respect to vertebral level and other ventral branches of the abdominal aorta. We have categorised the branching pattern of SMA into three different types depending upon the number of arterial pedicles, traced from proximal to distal to look into their anastomoses and formation marginal artery of Drummond.
Results: Vertebral level of origin of SMA varied between the lower third of twelfth thoracic vertebra (T12) and lower third of first lumbar vertebra (L1), most commonly arose at the level of the lower third of L1 (77.14%). The average distances between the origin of SMA and coeliac trunk (CT), inferior mesenteric artery (IMA) and aortic bifurcation were 1.84 cm, 6.67 cm and 10.39 cm, respectively. Depending on the branching pattern, type A was found in 29 (82.85%) cases, type B in 5 (14.28%) and type C in 1 (2.85%). In 2 cases (both of type B), the marginal artery was incomplete.
Conclusions: The most common topography of origin of the SMA was opposite the lower third of L1. The coeliac-superior mesenteric relationship was most consistent than between any other two points on the abdominal aorta; 85% of the SMAs were concentrated within a space of 1.00 cm (0.60–1.50 cm) from the CT. Type A branching pattern was most commonly seen in our study population.

Abstract

Background: The topographic location of the superior mesenteric artery (SMA) and its branching pattern are usually arbitrary in textbooks. This study, therefore, aims to provide topographic information of SMA with reference to the vertebral bodies, ventral branches of aorta and branching pattern of SMA.
Materials and methods: The study was conducted on 35 embalmed adult human cadavers. We performed detailed dissection of the SMA to topographically locate its origin in respect to vertebral level and other ventral branches of the abdominal aorta. We have categorised the branching pattern of SMA into three different types depending upon the number of arterial pedicles, traced from proximal to distal to look into their anastomoses and formation marginal artery of Drummond.
Results: Vertebral level of origin of SMA varied between the lower third of twelfth thoracic vertebra (T12) and lower third of first lumbar vertebra (L1), most commonly arose at the level of the lower third of L1 (77.14%). The average distances between the origin of SMA and coeliac trunk (CT), inferior mesenteric artery (IMA) and aortic bifurcation were 1.84 cm, 6.67 cm and 10.39 cm, respectively. Depending on the branching pattern, type A was found in 29 (82.85%) cases, type B in 5 (14.28%) and type C in 1 (2.85%). In 2 cases (both of type B), the marginal artery was incomplete.
Conclusions: The most common topography of origin of the SMA was opposite the lower third of L1. The coeliac-superior mesenteric relationship was most consistent than between any other two points on the abdominal aorta; 85% of the SMAs were concentrated within a space of 1.00 cm (0.60–1.50 cm) from the CT. Type A branching pattern was most commonly seen in our study population.

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Keywords

aortic bifurcation, coeliac artery, inferior mesenteric artery, superior mesenteric artery, topography

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Title

Topographic location and branching pattern of the superior mesenteric artery with its clinical relevance: a cadaveric study

Journal

Folia Morphologica

Issue

Vol 81, No 2 (2022)

Article type

Original article

Pages

372-378

Published online

2021-03-22

Page views

1301

Article views/downloads

680

DOI

10.5603/FM.a2021.0031

Pubmed

33778940

Bibliographic record

Folia Morphol 2022;81(2):372-378.

Keywords

aortic bifurcation
coeliac artery
inferior mesenteric artery
superior mesenteric artery
topography

Authors

S. Nigah
A. Patra
S. Chumbar
P. Chaudhary

References (27)
  1. Adachi B. Anatomie der Japaner I. Das Arterien system der Japaner. Band II Kaiserlich-Japanischen Universitätzu Kyoto, Kyoto Maruzen 1928: 20–71.
  2. Basmajian JV, Slonecker CE. Mesenteric vessels, Duodenum, and Pancreas. Grant´s Method of Anatomy. 11th ed. William & Wilkins, Baltimore 1980: 172–173.
  3. Benton RS, Cotter WB. A hitherto undocumented variation of the inferior mesenteric artery in man. Anat Rec. 1963; 145: 171–173.
  4. Corsy E, Aubert A. Artères de l'intestin grêle et des colons. Bibliogr Anat. 1913; 23: 221.
  5. Decker GAG, du Plesis DJ. Lee McGregor‘s: A Synopsis of Surgical Anatomy. 12th ed. Varghese Publishing House, Bombay : 226–228.
  6. Felix W. In: Keibel F, Mall FP. Manual of human embryology. Vol. 2, Chapter 19. JB Lippincott Co., Philadelphia 1912.
  7. George R. Topography of the unpaired visceral branches of the abdominal aorta. J Anat. 1935; 69(Pt 2): 196–205.
  8. Heidsieck E. Zur Skeletopie der grossen Äste der Bauchaorta. Anat Anz. 1928; 66: 6–24.
  9. Igiri AO, Ekong MB, Egemba GO, et al. The pattern of arrangement and distribution of the superior mesenteric artery in a Nigerian population. Int J Morphol. 2010; 28: 33–36.
  10. Kao G, Whittington R, Coia L. Anatomy of the celiac axis and superior mesenteric artery and its significance in radiation therapy. Int J Radial Oncol Biol Phys. 1993; 25(1): 131–134.
  11. Koizumi M, Horiguchi M. Accessory arteries supplying the human transverse colon. Acta Anat (Basel). 1990; 137(3): 246–251.
  12. Lorenzini L, Bertelli L, Lorenzi M. La disposizione arteriosa nel territorio della flessura colica sinistra [Arterial supply in the left colonic flexure]. Ann Ital Chir. 1999; 70(5): 691–698.
  13. Mane D, Shinde D. A Morphometric study of superior mesenteric artery and its implication in laparoscopic Surgery. Int J Med Res Rev. 2015; 3(4): 372–377.
  14. Michels NA, Siddharth P, Kornblith PL, et al. The variant blood supply to the descending colon, rectosigmoid and rectum based on 400 dissections. Its importance in regional resections: A review of medical literature. Dis Colon Rectum. 1965; 8: 251–278.
  15. Nelson T, Pollak R, Jonasson O, et al. Anatomic variants of the celiac, superior mesenteric, and inferior mesenteric arteries and their clinical relevance. Clin Anat. 1988; 1(2): 75–91.
  16. Oran I, Yesildag A, Memis A. Aortic origin of right hepatic artery and superior mesenteric origin of splenic artery: two rare variations demonstrated angiographically. Surg Radiol Anat. 2001; 23(5): 349–352.
  17. Romanes GJ. The abdominal cavity. Cunningham’s Manual of Practical Anatomy. Thorax and Abdomen. 5th ed. Oxford University Press, London 2000: 135–136.
  18. Romanes GJ. Cunningham’s Manual of Practical Anatomy. Thorax and Abdomen. 5th ed. Oxford University Press, London 2004: 137.
  19. Sato O, Matsumoto I, Kondoh K. Middle mesenteric artery encountered during abdominal aortic aneurysm surgery. Jpn J Vasc Surg. 2007; 16(7): 799–801.
  20. Schoenwolf GC, Bleyl SB, Brauer PR, Fracis-West PH. Development of the gastrointestinal tract.Larsen’s Human Embryology, 4th ed. Churchill Livingstone Elsevier, Philadelphia 2009: 441–442.
  21. Songür A, Toktaş M, Alkoç O, et al. Abdominal Aorta and Its Branches:Morphometry - Variations In Autopsy Cases. Eur J Gen Med. 2010; 7(3): 321–325.
  22. Steward JA, Rankin FW. Blood supply of the large intestines: its surgical consideration. Arch Surg. 1933; 26(5): 843–891.
  23. Tandler J. Zur Entwicklungsgeschichte der menschlichen Darmarterien. Anat Hefte. Beiträge und Referate zur Anatomie und Entwickelungsgeschichte. 1903; 23(1): 188–210.
  24. Taniguchi J. Beitrag zur Topographic der grossen Aste der Bauchaorta. Folia Anat Jpn. 1931; 9(3-4): 201–214.
  25. Tanuma K, Kitazawa M, Itonaga T, et al. Four cases with the splenic artery of abnormal origin. Kaibogaku Zasshi. 1986; 61(2): 130–137.
  26. Williams PL, Bannister LH, Berry MM. Gray’s anatomy. 38th ed. Churchill Livingstone, London 1995: 1553–1554.
  27. Yoo SJ, Ku MJ, Cho SaS, et al. A case of the inferior mesenteric artery arising from the superior mesenteric artery in a Korean woman. J Korean Med Sci. 2011; 26(10): 1382–1385.

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