CT Imaging of Acute Bowel Ischemia and Infarction - Department of ...
CT Imaging of Acute Bowel Ischemia and Infarction - Department of ...
CT Imaging of Acute Bowel Ischemia and Infarction - Department of ...
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Anatomy<br />
Vascular Supply <strong>of</strong> <strong>Bowel</strong>: Arterial<br />
• 1. Celiac = distal esophagus to descending duodenum<br />
– GDA (first branch <strong>of</strong> CHA) = anastomotic connections b/w celiac axis <strong>and</strong> SMA<br />
• 2. SMA = transverse duodenum to splenic flexure<br />
– Marginal artery <strong>of</strong> Drummond/ arcade <strong>of</strong> Riolan = anastomotic connections b/w<br />
SMA <strong>and</strong> IMA Distribution provides clues to etiology…<br />
• 3. IMA = splenic flexure to rectum<br />
(b) SMA = jejunum, ileum, ascending, transverse<br />
– Anastomotic connections to lumbar arteries (<strong>of</strong>f abdominal aorta) <strong>and</strong> internal<br />
(c) IMA = descending (rectum spared)<br />
iliacs<br />
• Watershed areas:<br />
– Splenic flexure<br />
– Ileocecal junction<br />
– Rectosigmoid junction<br />
A. Vascular territories<br />
(a) Celiac = duodenum<br />
B. Watershed territories
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