Branching pattern of the colic branches of superior mesenteric artery-a cadaveric study

Original Article PURPOSE: A thorough knowledge of the anatomy of colonic mesenteric arteries is necessary to accomplish successful uncomplicated abdominal operations, especially laparoscopic colonic resections in which the mesenteric vessels can't be palpated. Such knowledge is also important when performing a colonic resection for cancer using proximal vascular ligation and wide en bloc resection. Most surgical textbooks depict a "normal pattern" of arterial supply to the ascending and right 2/3 of transvesre colon consists of three arterial branches the ileocolic artery(ICA), right colic artery(RCA) and the middle colic artery(MCA) arising independently from the superior mesenteric artery (SMA). Based on the literature, there are only two colonic arteries arising independently from the SMA in many cases. METHOD: In this study we mainly observed the branching pattern of colic branches of superior mesenteric arteries in 50 embalmed cadavers. RESULTS: In 90% cases the middle colic artery and in 66% the ileocolic artery arose directly from the SMA, the most variable artery was the RCA. In 46% cases, the RCA arose as a direct branch from SMA where as in 10% cases it formed a common stem with MCA and in 34% with ICA. The RCA was absent in 10% of cases. CONCLUSION: Knowledge of the colic vascular territories of the mesenteric arteries has a special interest in surgical practice because of the difficult post-operatory revitalization of the colon. Therefore these findings will be of great help for surgeons and radiologists