Inferior mesenteric artery explained

Inferior mesenteric artery
Latin:arteria mesenterica inferior
Branchfrom:Abdominal aorta
Branchto:Left colic artery, sigmoid branches, superior rectal artery
Vein:Inferior mesenteric vein
Precursor:Vitelline arteries
Supplies:Large Intestine

In human anatomy, the inferior mesenteric artery (IMA) is the third main branch of the abdominal aorta and arises at the level of L3, supplying the large intestine from the distal transverse colon to the upper part of the anal canal. The regions supplied by the IMA are the descending colon, the sigmoid colon, and part of the rectum.[1]

Structure

Origin

The IMA arises from the anterior aspect of the abdominal aorta.

Its origin is situated at the L3 vertebral level,[2] below the origins of the two renal arteries, 3-4 cm above the aortic bifurcation,[3] at the level of the umbilicus, and posterior to the inferior border of the horizontal (III) part of the duodenum.

Branches

Along its course, the IMA has the following branches:[4]

Branch notes - - the most superior being described as 'the superior sigmoid artery' - superior rectal arteryeffectively the terminal branch of the IMA (the continuation of the IMA after all other branches)

All these arterial branches further divide into arcades which then supply the colon at regular intervals.

Relations

The IMA is accompanied along its course by a similarly named vein, the inferior mesenteric vein, which drains into the splenic vein. The IMV drains to the portal vein and does therefore not fully mirror the course of the IMA.

Distribution

Proximally, its territory of distribution overlaps (forms a watershed) with the middle colic artery, and therefore the superior mesenteric artery. The SMA and IMA anastomose via the marginal artery of the colon (artery of Drummond) and via Riolan's arcade (also called the "meandering artery", an arterial connection between the left colic artery and the middle colic artery). The territory of distribution of the IMA is more or less equivalent to the embryonic hindgut.

Clinical significance

The IMA and/or its branches must be resected for a left hemicolectomy.[5]

A horseshoe kidney, a common (1 in 500) anomaly of the kidneys, will be positioned below the IMA.[6] [7]

External links

Notes and References

  1. Book: Standring, Susan . Gray's anatomy: the anatomical basis of clinical practice. 2016 . 978-0-7020-5230-9 . 41st . Elsevier Limited . Philadelphia . 920806541.
  2. Book: Sinnatamby, Chummy . Last's Anatomy . 2011 . 978-0-7295-3752-0 . 12th . 246.
  3. Book: Drake . Richard L. . Gray's anatomy for students . Vogl . Wayne . Mitchell . Adam W. M. . Gray . Henry . 15 November 2015 . Churchill Livingstone/Elsevier . 978-0-7020-5131-9 . 3rd . Philadelphia, PA . 881508489.
  4. Book: Moore . Keith L. . Clinically oriented anatomy . Dalley . Arthur F. II . Agur . A. M. R. . 13 February 2013 . Wolters Kluwer Health/Lippincott Williams & Wilkins . 978-1-4511-1945-9 . 7th . Philadelphia . 813301028.
  5. Charan. Ishwar . Kapoor. Akhil. Singhal. Mukesh Kumar . Jagawat. Namrata. Bhavsar. Deepak. Jain. Vikas. Kumar. Vanita. Kumar. Harvindra Singh. December 2015. High Ligation of Inferior Mesenteric Artery in Left Colonic and Rectal Cancers: Lymph Node Yield and Survival Benefit . The Indian Journal of Surgery . 77. Suppl 3. 1103–1108. 10.1007/s12262-014-1179-2. 0972-2068. 4775673. 27011519 .
  6. Schiappacasse . G. Aguirre. J. Soffia. P. Silva. C S. Zilleruelo. N. January 2015. CT findings of the main pathological conditions associated with horseshoe kidneys . The British Journal of Radiology . 88 . 1045 . 10.1259/bjr.20140456. 0007-1285. 4277381. 25375751 .
  7. Web site: Clinical case: Horseshoe kidney transplantation . Kenhub. 2019-09-28.