Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Abdomen: Variations in Branches of Celiac Trunk

Superior Mesenteric Artery

Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD
Peer Review Status: Internally Peer Reviewed

The variations in this artery are very common and numerous.

The artery may be doubled, arising from the aorta as two trunks.

On occasion it provides accessory branches to the liver, stomach, pancreas, spleen and gallbladder.

The artery may give rise to branches usually derived from other sources: the hepatic or its right or left branch, the cystic, the gastroduodenal or its right epiploic branch, the left gastric, an accessory colic (superior left colic artery) or a larger pancreatic branch. Koizumi and Horiguchi (1990) found an accessory colic artery which arose from the superior mesenteric artery more proximal than the first jejunal artery and met the marginal artery at the splenic flexure; it was reported found in 32 of 65 subjects (49.2%). The authors, noting the constant nature of this unnamed artery proposed the name "superior left colic artery (arteria colica sinistra superior; CSS)". The authors also found an additional epiploic branch derived from the pancreatic branch (posterior epiploic branch), which also sent an accessory colic artery in two subjects. The latter two examples were not considered equivalent to the superior left colic artery.

In some cases, it gives rise to the left colic and superior hemorrhoidal (NA, superior rectal), thus wholly or partly replacing the inferior mesenteric artery.

The inferior mesenteric artery may arise from the superior mesenteric instead of from the aorta.

The superior mesenteric artery sometimes arises from, or in common with, the celiac trunk.

The colic and intestinal branches of this artery may vary considerably in their origin and course, and in the number of primary and secondary loops they form.

A rare variation is the persistence of an omphalomesenteric artery running near the umbilicus and providing a branch to the urachus, to the liver through the falciform ligament, or to the rectus abdominis muscle anastomosing with the epigastric artery.

As many as nine to eighteen of its branches supply the jejunum and ileum, although an eleven to fourteen branch supply is most common. The minimum/maximum range for the jejunum and ileum is six to twenty-one branches.

Image 14, Image 96, Image 101, Image 254A, Image 333

Branches of:

See Images 14, 96, 254A, 340

Gastroduodenal

Image 17, See Image 101, Image 108

Right Gastroepiploic

See Image 101, Image 254B

Dorsal Pancreatic

See Image 101

Appendiceal

See Image 14, Image 347

Cecal

See Images 14, 347

Celiacomesenteric Trunk

Image 237, See Image 333

Middle Colic

See Image 101

Superior Mesenteric-Inferior Mesenteric Trunk

See Image 237

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Variations in Branches of the Superior Mesenteric Artery

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