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Anatomy Atlases: Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Abdomen: Variations in Branches of the Superior Mesenteric Artery

Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Abdomen

Variations in Branches of the Superior Mesenteric Artery

Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD

Peer Review Status: Internally Peer Reviewed

Several variations in the branches of the superior mesenteric artery have been recorded.

Inconstant branches have been noted. These are the dorsal pancreatic (21% of cases studied), inferior pancreatic, right hepatic (accessory or replacing, 14%), common hepatic, and accessory middle colic. In some cases, the inferior mesenteric, splenic, gastroduodenal, right gastroepiploic, or even the cystic artery arise from the superior mesenteric.

Of the more constant branches, a single middle colic is most common (88% of cases studied); it may arise independently from the the superior mesenteric (60%) or from a common stem with the right colic (25%), or from the splenic artery.

Accessory middle colics (superior left colic artery) [see also above, superior mesenteric artery] arise from the superior mesenteric in about 9% of individuals. In 27%, an additional large left branch courses to the left colic flexure, ramifying to supply that area. The dorsal pancreatic and inferior pancreatic sometimes arise from the middle colic. The middle colic artery may also arise from the inferior mesenteric artery or from the splenic artery. The middle colic is absent in 3% (in another study it was absent in 51% of cases) of cases studied.

The right colic is a single vessel in 78% of individuals, and arises independently from the superior mesenteric in only 28% of the population. Most frequently, it arises with, or as a branch of the middle colic, ileocolic, or the left colic arteries. It is absent in 13% of individuals.

The appendicular branch of the ileocolic has a variable origin, in the ileocolic or its terminal branches (ileal, posterior cecal, anterior cecal.) It typically passes dorsal to the ileum to enter the free border of the mesenteriolum of the appendix. The vessel may be doubled and may pass ventral of the mesenteriolum of the appendix. The vessel may be doubled and may pass ventral to the ileum to supply the appendix.

The ileocolic arises independently from the superior mesenteric in 63% of individuals; in the remainder, it arises as a common trunk, usually with the right colic to the ascending colon.

The left colic artery may be a branch of the superior mesenteric artery.

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