Superior mesenteric artery 1926100 224589213 2008-07-09T15:28:41Z 80.124.167.40 /* Pathology */ {{Infobox Artery | Name = {{PAGENAME}} | Latin = arteria mesenterica superior | GraySubject = 154 | GrayPage = 606 | Image = Gray1099.png | Caption = The pancreas and duodenum from behind. (Superior mesenteric artery labeled at upper right.) | Image2 = Superior_mesenteric_a.gif | Caption2 = 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. | BranchFrom = [[abdominal aorta]] | BranchTo = [[inferior pancreaticoduodenal artery|inferior pancreaticoduodenal]]<BR>[[middle colic artery|middle colic]]<BR>[[right colic artery|right colic]]<BR>intestinal branches ([[jejunal arteries|jejunal]], [[ileal arteries|ileal]])<BR> [[ileocolic artery|ileocolic]] | Vein = [[superior mesenteric vein]] | Precursor = [[vitelline arteries]] | Supplies = [[intestine]] | MeshName = Mesenteric+Artery,+Superior | MeshNumber = A07.231.114.565.755 | DorlandsPre = a_61 | DorlandsSuf = 12155072 | }} See also: [[Superior Mesenteric Artery Syndrome]] 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 artery|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: * left [[renal vein]] - travels between the left [[kidney]] and the [[inferior vena cava]] (can be compressed by the SMA at this location, leading to [[Nutcracker Syndrome]]. * the third part of the [[duodenum]], a segment of the [[small intestines]] (can be compressed by the SMA at this location, leading to [[Superior Mesenteric Artery Syndrome]]). * uncinate process of the [[pancreas]] - this is a small part of the pancreas that hooks around the SMA. 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== {| class="wikitable" | '''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 [[vermiform appendix|appendix]] |} The middle, right, and [[ileocecal]] branches anastomose with each other to form a [[marginal artery of the colon|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 [[ischemic colitis|intestinal ischemia]] and often has devastating consequences; up to 80% of SMA occlusions lead to death.<ref>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. [http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowFulltext&ProduktNr=223996&Ausgabe=225603&ArtikelNr=18587 Full Text].</ref> * The SMA can compress the left [[renal vein]], leading to the [[nutcracker syndrome]] and/or the third (horizontal) part of the [[duodenum]], leading to [[Wilkie's Syndrome (Superior Mesenteric Artery Syndrome)]]. ==Additional images== <gallery> Image:Gray533.png|The celiac artery and its branches; the stomach has been raised and the peritoneum removed. Image:Gray985.png|Abdominal part of digestive tube and its attachment to the primitive or common mesentery. Human embryo of six weeks. Image:Gray1121.png|Posterior abdominal wall, after removal of the peritoneum, showing kidneys, suprarenal capsules, and great vessels. Image:Gray1122.png|The anterior surfaces of the kidneys, showing the areas of contact of neighboring viscera. Image:Gray1227.png|Front of abdomen, showing surface markings for arteries and inguinal canal. </gallery> ==References== <references/> ==External links== * {{SUNYAnatomyFigs|39|02|01}} - "Branches of the inferior mesenteric artery." * {{SUNYAnatomyLabs|40|11|01|02}} - "Posterior Abdominal Wall: Branches of the Abdominal Aorta" * {{SUNYAnatomyImage|8|0|08}} * {{SUNYAnatomyImage|8|4|04}} * {{SUNYAnatomyImage|8|8|15}} * {{SUNYAnatomyImage|8|8|41}} * {{UMichAtlas|abdo_wall70}} - "Posterior Abdominal Wall, Dissection, Anterior View" * {{NormanAnatomy|sup&infmesentericart}} {{Arteries of thorax and abdomen}} [[Category:Arteries]] [[Category:Abdomen]] [[de:Arteria mesenterica superior]] [[es:Arteria mesentérica superior]] [[fr:Artère mésentérique supérieure]] [[la:Arteria mesenterica superior]] [[hu:Arteria mesenterica superior]] [[pl:Tętnica krezkowa górna]] [[pt:Artéria mesentérica superior]] [[fi:Ylempi suolilievevaltimo]]