Blood Supply of the Gastrointestinal Tract

1. Celiac Artery
‡ The lower one third of the esophagus to the middle of the second part of the duodenum ‡ very short ‡ 12th thoracic vertebra ‡ surrounded by the celiac plexus ‡ behind the lesser sac of peritoneum. ‡ branches: the left gastric, splenic, and hepatic arteries

a.
‡ ‡ ‡

Left Gastric Artery runs to the cardiac end of the stomach esophageal branches along the lesser curvature of the stomach. It anastomoses with the right gastric artery

‡

b. Splenic Artery
‡ runs to the left in a wavy course ‡ along the upper border of the pancreas ‡ behind the stomach. Branches

Pancreatic branches left gastroepiploic artery short gastric arteries

The left gastroepiploic artery
‡ near the hilum of the spleen ‡ reaches the greater curvature of the stomach in the gastrosplenic omentum. ‡ along the greater curvature of the stomach between the layers of the greater omentum. ‡ It anastomoses with the right gastroepiploic artery

The short gastric arteries
‡ ‡

five or six in number arise from the end of the splenic artery and reach the fundus of the stomach in the gastrosplenic omentum. ‡ They anastomose with the left gastric artery and the left gastroepiploic artery

c. Hepatic Artery
‡ runs forward and to the right and then ascends ‡ At the porta hepatis it divides into right and left branches to supply the corresponding lobes of the liver.

Branches: The right gastric artery The gastroduodenal artery The right and left hepatic arteries

Branches of the Hepatic The right gastric artery ‡ arises from the hepatic artery at the upper border of the pylorus ‡ runs to the left along the lesser curvature of the stomach ‡ It anastomoses with the left gastric artery

The Gastroduodenal artery ‡ descends behind the first part of the duodenum ‡ divides into: right Gastroepiploic artery runs along the greater curvature of the stomach superior pancreaticoduodenal artery descends between the second part of the duodenum and the head of the pancreas .

The right and left hepatic arteries ‡ enter the porta hepatis. ‡ The right hepatic artery usually gives off the cystic artery,

2. Superior Mesenteric Artery
‡ The middle of the second part of the duodenum as far as the distal third of the transverse colon. ‡ runs downward and to the right behind the neck of the pancreas and in front of the third part of the duodenum. ‡ continues downward to the right ‡ ends by anastomosing with the ileal branch of its own ileocolic branch

Branches: The inferior pancreaticoduodenal artery ‡ passes to the right ‡ along the upper border of the third part of the duodenum and the head of the pancreas. ‡ It supplies the pancreas and the adjoining part of the duodenum.

The middle colic artery
‡ runs forward in the transverse mesocolon ‡ supply the transverse colon ‡ divides into right and left branches

The right colic artery
‡ is often a branch of the ileocolic artery. ‡ It passes to the right ‡ supply the ascending colon ‡ divides into ascending and descending branches

The ileocolic artery
‡ passes downward and to the right. superior branch anastomoses with the right colic artery inferior branch anastomoses with superior mesenteric artery. ‡ The inferior branch gives rise to the anterior and posterior cecal arteries ‡ the appendicular artery is a branch of the posterior cecal

artery

The jejunal and ileal branches ‡ 12 to 15 in number ‡ arise from the left side of the superior mesenteric ‡ branching and anastomosis( arcades). ‡ Fewer arcades supply the jejunum than supply the ileum.

3. Inferior Mesenteric Artery
‡ The distal one third of the transverse colon to halfway down the anal canal. ‡ runs downward and to the left ‡ crosses the left common iliac artery (becomes the superior rectal artery

Branches The left colic artery ‡ runs upward and to the left ‡ distal third of the transverse colon, the left colic flexure, and the upper part of the descending colon ‡ ascending and descending branches.

The sigmoid arteries ‡ two or three in number ‡ descending and sigmoid colon

The superior rectal artery ‡ continuation of the inferior mesenteric artery as it crosses the left common iliac artery ‡ the rectum and upper half of the anal canal ‡ anastomoses with the middle rectal and inferior rectal arteries.

***Marginal Artery ‡ The anastomosis of the colic arteries ‡ ileocecal junction -------- superior rectal artery

Venous Drainage
‡ drains to the liver by the portal venous system. ‡ The proximal tributaries drain directly into the portal vein ‡ distal tributaries correspond to the branches of the celiac artery and the superior and inferior mesenteric arteries

Hepatic Portal Vein
‡
‡ ‡ ‡ ‡ ‡ drains lower third of the esophagus to halfway down the anal canal enters the liver and breaks up into sinusoids The portal vein is about 2 in. (5 cm) union of the superior mesenteric and splenic veins behind the neck of the pancreas ascends to the right, behind the first part of the duodenum, and enters the lesser omentum. begins as a capillary plexus and ends as a capillary plexsus

Tributaries of the Portal Vein
1. Splenic vein: leaves the hilum of the spleen and passes to the right in the splenicorenal ligament unites with the superior mesenteric vein behind the neck of the pancreas to form the portal vein receives the short gastric, left gastroepiploic, inferior mesenteric, and pancreatic veins.

2. Inferior mesenteric vein: ‡ ascends on the posterior abdominal wall and ‡ joins the splenic vein ‡ receives the superior rectal veins, the sigmoid veins, and the left colic vein.

3. Superior mesenteric vein: ‡ ascends in the root of the mesentery ‡ passes in front of the 3rd part of the duodenum ‡ joins the splenic vein ‡ receives the jejunal, ileal, ileocolic, right colic, middle colic, inferior pancreaticoduodenal, and right gastroepiploic veins

4. Left gastric vein drains the left portion of the lesser curvature of the stomach and the distal part of the esophagus. 5. Right gastric vein: drains the right portion of the lesser curvature of the stomach 6. Cystic veins drain the gallbladder directly into the liver or join the portal vein

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