Mesenteric Vasculature and Collateral Pathways

ABSTRACT

The arterial and venous circulation of the bowel is complex and is characterized by marked redundancy of multiple interconnecting branches, which provides a rich blood supply to aid in the digestive process and also serves to protect the bowel from potential ischemia or infarction. As a result of this circulatory pattern, anatomic variants and extensive collateral pathways are common. A thorough knowledge of both the arterial and venous mesenteric circulation, including normal, variant, and collateral anatomy, is necessary for the appropriate evaluation and management of the various disease processes that may affect the vascular supply of the gastrointestinal system.

KEYWORDS

Mesenteric circulation - mesenteric collateral pathways - variant arterial anatomy

REFERENCES

• 1 Reuter S R, Redman H C, Cho K J. Gastrointestinal Angiography. 3rd ed. Philadelphia, PA; WB Saunders 1986
• 2 Kaufman J A, Lee M J. Vascular and Interventional Radiology: The Requisites. St. Louis, MO; Mosby 2004
• 3 Petscavage J M, Maldjian P. Celiomesenteric trunk: two variants of a rare anomaly.  Australas Radiol. 2007;  51(Suppl) B306-B309
• 4 Iezzi R, Cotroneo A R, Giancristofaro D, Santoro M, Storto M L. Multidetector-row CT angiographic imaging of the celiac trunk: anatomy and normal variants.  Surg Radiol Anat. 2008;  30(4) 303-310
• 5 McNulty J G, Hickey N, Khosa F, O'Brien P, O'Callaghan J P. Surgical and radiological significance of variants of Bühler's anastomotic artery: a report of three cases.  Surg Radiol Anat. 2001;  23(4) 277-280
• 6 Saad W E, Davies M G, Sahler L et al.. Arc of Buhler: incidence and diameter in asymptomatic individuals.  Vasc Endovascular Surg. 2005;  39(4) 347-349
• 7 Winston C B, Lee N A, Jarnagin W R et al.. CT angiography for delineation of celiac and superior mesenteric artery variants in patients undergoing hepatobiliary and pancreatic surgery.  AJR Am J Roentgenol. 2007;  189(1) W13–W19
• 8 Koops A, Wojciechowski B, Broering D C, Adam G, Krupski-Berdien G. Anatomic variations of the hepatic arteries in 604 selective celiac and superior mesenteric angiographies.  Surg Radiol Anat. 2004;  26(3) 239-244
• 9 Covey A M, Brody L A, Maluccio M A, Getrajdman G I, Brown K T. Variant hepatic arterial anatomy revisited: digital subtraction angiography performed in 600 patients.  Radiology. 2002;  224(2) 542-547
• 10 Koç Z, Oğuzkurt L, Ulusan S. Portal vein variations: clinical implications and frequencies in routine abdominal multidetector CT.  Diagn Interv Radiol. 2007;  13(2) 75-80
• 11 Gallego C, Velasco M, Marcuello P, Tejedor D, De Campo L, Friera A. Congenital and acquired anomalies of the portal venous system.  Radiographics. 2002;  22(1) 141-159
• 12 Song S Y, Chung J W, Kwon J W et al.. Collateral pathways in patients with celiac axis stenosis: angiographic-spiral CT correlation.  Radiographics. 2002;  22(4) 881-893
• 13 Fisher Jr D F, Fry W J. Collateral mesenteric circulation.  Surg Gynecol Obstet. 1987;  164(5) 487-492
• 14 Horton K M, Fishman E K. Volume-rendered 3D CT of the mesenteric vasculature: normal anatomy, anatomic variants, and pathologic conditions.  Radiographics. 2002;  22(1) 161-172
• 15 Gourley E J, Gering S A. The meandering mesenteric artery: a historic review and surgical implications.  Dis Colon Rectum. 2005;  48(5) 996-1000
• 16 Lin P H, Chaikof E L. Embryology, anatomy, and surgical exposure of the great abdominal vessels.  Surg Clin North Am. 2000;  80(1) 417-433, xiv
• 17 Rosenblum J D, Boyle C M, Schwartz L B. The mesenteric circulation. Anatomy and physiology.  Surg Clin North Am. 1997;  77(2) 289-306