Superior mesenteric artery

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Artery: Superior mesenteric artery
The pancreas and duodenum from behind. (Superior mesenteric artery labeled at upper right.)
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.
Latin	arteria mesenterica superior
Gray's	subject #154 606
Supplies	intestine
Source	abdominal aorta
Branches	inferior pancreaticoduodenal middle colic right colic intestinal branches (jejunal, ileal) ileocolic
Vein	superior mesenteric vein
Precursor	vitelline arteries
MeSH	Mesenteric+Artery,+Superior
Dorlands / Elsevier	a_61/12155072

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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 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 the so-called nutcracker syndrome.
• the third part of the duodenum, part of the small intestines
• 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

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 appendix

The middle, right, and ileocecal branches anastomose with each other to form a 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 intestinal ischemia and often has devastating consequences; up to 80% of SMA occlusions lead to death.^[1]
• The SMA can compress the left renal vein, leading to the nutcracker syndrome and/or the third (horizontal) part of the duodenum, leading to SMA syndrome.

Additional images

The celiac artery and its branches; the stomach has been raised and the peritoneum removed.	Abdominal part of digestive tube and its attachment to the primitive or common mesentery. Human embryo of six weeks.	Posterior abdominal wall, after removal of the peritoneum, showing kidneys, suprarenal capsules, and great vessels.	The anterior surfaces of the kidneys, showing the areas of contact of neighboring viscera.
Front of abdomen, showing surface markings for arteries and inguinal canal.

References

External links

• SUNY Figs 39:02-01 - "Branches of the inferior mesenteric artery."
• SUNY Labs 40:11-0102 - "Posterior Abdominal Wall: Branches of the Abdominal Aorta"
• SUNY Anatomy Image 8008
• SUNY Anatomy Image 8404
• SUNY Anatomy Image 8815
• SUNY Anatomy Image 8841
• Atlas of anatomy at UMich abdo_wall70 - "Posterior Abdominal Wall, Dissection, Anterior View"
• Norman/Georgetown sup&infmesentericart

v • d • e Arteries of torso - abdomen
AA: Anterior	celiac left gastric splenic: pancreatic branches (arteria pancreatica magna) – short gastric – left gastro-omental common hepatic: proper hepatic (cystic), right gastric, gastroduodenal (right gastro-omental, superior pancreaticoduodenal) SMA inferior pancreaticoduodenal – intestinal – ileocolic (appendicular) – right colic – middle colic IMA left colic – sigmoid – superior rectal – marginal
AA: Posterior	visceral: middle suprarenal – renal (inferior suprarenal) – testicular/ovarian parietal: inferior phrenic (superior suprarenal) – lumbar – median sacral terminal: common iliac (IIA, EIA)
IIA: Anterior	umbilical (superior vesical, to ductus deferens) – inferior vesical – middle rectal – uterine (azygos of the vagina) – vaginal – obturator (anterior branch, posterior branch) – internal pudendal (inferior rectal, perineal, artery of the urethral bulb, urethral, deep artery of the penis, dorsal artery of the penis) – inferior gluteal (accompanying of ischiadic nerve, crucial anastomosis)
IIA: Posterior	iliolumbar – lateral sacral – superior gluteal
EIA	inferior epigastric (cremasteric) – deep circumflex iliac

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Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .

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