Accessory Middle Colic Artery Research Articles

Preoperative Evaluation of Blood Vessel Anatomy Using 3-Dimensional Computed Tomography for Laparoscopic Surgery of Transverse Colon Cancer

This study describes the efficacy of the evaluation of blood vessel anatomy by 3-dimensional computed tomography (3D-CT) for laparoscopic surgery for transverse colon cancer (TCC). A total of 102 patients with TCC were examined by preoperative 3D-CT to clarify their blood vessel anatomy at Tokyo Medical University Hospital between January 2010 and December 2015, before undergoing laparoscopic surgery using the obtained 3D-CT data. Regarding blood vessel variation, the middle colic artery (MCA) was present in all patients (100%). The common duct type was observed in 89 patients (87.3%), and a type of branch separate from the superior mesenteric artery was observed in 13 patients (12.7%). The accessory MCA was present in 25 patients (24.5%). The middle colic vein was present in all patients (100%), and it drained into the following vessels: the superior mesenteric vein, gastrocolic trunk, first jejunal vein, and inferior mesenteric vein [67 (65.8%), 25 (24.5%) 8 (7.8%), and 2 (1.9%) patients, respectively]. Regarding the surgical outcome, the bleeding volume was 43 g, the operative time was 218 minutes, the number of harvested lymph nodes was 21, the proximal resection margin was 164 mm, the distal resection margin was 105 mm, and the length of postoperative hospital stay was 10 days. Although complicated variations and anomalies in the MCA and the contiguous veins were observed, preoperative 3D-CT will be useful for surgeons performing laparoscopic surgery on patients with TCC.

Variations in the Vascular Anatomy of the Right Colon and Implications for Right-Sided Colon Surgery.

Knowledge of the normal pattern and variations of the blood supply of the right colon is crucial for better outcomes after colon surgery. The purpose of this study was to describe the precise vascular anatomy of the right colon according to surgical perspective. Adult fresh cadavers were dissected between January 2013 and October 2015, focusing on the venous and arterial anatomy of the right side of the colon. Macroscopic anatomical dissections were performed on 111 adult fresh cadavers with emphasis on the vascular anatomy of the right colon. The colic tributaries of the superior mesenteric artery and vein were documented in writing. Furthermore, the dissections were recorded with a video camera. The incidence of colic arteries arising from the superior mesenteric artery included ileocolic artery, 100%; right colic artery, 33.3%; middle colic artery, 100%; and accessory middle colic artery, 11,7%. All 111 cadavers had a single ileocolic vein, which drained into the superior mesenteric vein in 103 cases (92.8%), into the gastro-pancreatico-colic trunk in 7 cases (6.3%), and into the jejunal trunk in 1 case (0.9%). The drainage site of the ileocolic vein to the superior mesenteric vein varied, and in 9% of cases the ileocolic vein did not accompany the ileocolic artery. The gastro-pancreatico-colic trunk was detected in 87 cases (78.4%); with several forms of the origin of the respective branches, the gastropancreatic trunk was detected in 24 cases (21.6), and the classic gastrocolic trunk of Henle was not detected. Variations were found in the formation and drainage routes of other venous colic tributaries of the superior mesenteric vein. This study is limited by its use of cadavers in that it is impossible to trace each vessel to its origin in live surgery. Surgeons must watch, observe, and bear in mind that vascular variations can occur. Awareness of these complex variations may improve the quality of surgery and may prevent devastating complications during right-sided colon resections.

A direct anastomosis between the stems of celiac trunk and left colic artery by an anomalous fourth celiac trunk branch: First cadaveric study

Coeliac trunk (CT) is a ventral branch of abdominal aorta (AA) supplying the foregut through its three main branches, left gastric (LGA), common hepatic (CHA) and splenic artery (Standring et al., 2009). Branching pattern of CT may vary from above mentioned classical three to four, five or six. Additional branches include inferior phrenic artery, dorsal pancreatic artery, middle colic or accessory middle colic artery (Hamilton and Mossman, 1972; Amonoo-Kuofi et al., 1995). Anastmosis between CT and Superior mesenteric artery (SMA) which supplies the midgut derivatives in the form of Bühler's arcade (1-2%) is present posterior to the body of pancreas (Douard et al., 2006; McNulty et al., 2001). Anastomoses between SMA and Inferior mesenteric artery (IMA) which supplies hindgut derivatives are also documented (Lange et al, 2007; Van Damme and Bonte, 1990). Until recently no communications between arteries of foregut and hindgut were reported (Manoharan et al., 2010; Patel et al., 2010; Stimec et al., 2011). We report the first cadaveric finding demonstrating a direct communication between the stems of CT and left colic artery (LCA) via a fourth anomalous CT branch in the absence of any co-existing stenosis or aneurysm in the main vessels.

A case of superior mesenteric artery syndrome after left hemicolectomy for descending colon cancer

A 58-year-old man was diagnosed as having descending colon cancer and underwent a left colectomy with D3 node dissection and end-to-end anastomosis reconstruction. The accessory middle colic artery was secured as a feeding artery, and the middle colic artery was preserved. Diet was started on postoperative day 5 (POD5), and nausea and vomiting appeared on POD10. An upper gastrointestinal series revealed to-and-fro peristalsis in the third portion of the duodenum and dilatation of the proximal duodenum. Abdominal CT showed that the second portion of the duodenum was markedly dilated and the third portion was compressed by the superior mesenteric artery (SMA). As a result, he was diagnosed with post-operative superior mesenteric artery syndrome (SMAS) and treated with conservative therapy. The symptoms improved with a nasogastric tube, and he started to eat after POD26, followed by a successful outcome.

Digital subtraction angiography of the superior mesenteric artery: Identifying arterial branches

This "problem in diagnostic imaging" provides an overview of the technique of digital subtraction angiography. The possibility of artefacts arising from movement subsequent to the taking of the masking image is discussed. It is also important that contrast medium is allowed to backflow into the parent vessel (in this case the aorta) to ensure that there has been filling of the proximal branches of the vessel of interest (in this case the superior mesenteric artery). An accessory middle colic artery is demonstrated. Detection of such variant vessels is important not only to surgeons but also to specialist radiologists carrying out therapeutic embolization.

Surgical anatomy of the colic vessels in Chinese and its influence on the operation of esophageal replacement with colon

To investigate the configuration of colic vessels in Chinese and its influence on the operation of esophageal replacement with colon (ERC). The origin, trend, branching, configuration, and distribution of the colic vessels, the intensity of the colic arterial impulse, the integrity of the marginal artery at the splenic flexure and hepatic flexure of colon were observed during the operation of ERC among 582 patients undergoing ERC, 402 males mad 180 females, aged 2 approximately 74, from 22 provinces, municipality, and autonomous regions. The left colic artery (LCA) stemmed from the inferior mesenteric artery (IMA) in 97.3% of the patients, with an absence rate of 0.7%. The middle colic artery (MCA) stemmed from the superior mesenteric artery (SMA) in 77.8% of the patients with an absence rate of 8.2%. Accessory middle colic artery (acMCA), originating from the right colic artery, could be seen in 6.2% of the patients 39.7% of the right colic artery (RCA) stemmed from the SMA by itself, 23.0% of the RMA stemmed together with MCA, and 28.0% of the RCA stemmed together with the ileocolic artery. The absence rate of RCA was 9.8%. The intactness rate of marginal artery was 96.8% at the splenic flexure of colon, and was 88.7% at the hepatic flexure. The Rolan arch was seen in only 7.6% of the patients. The configuration of colic vessels in Chinese was basically similar to those of the results of autopsies carried out abroad. The optimal supply artery of colic segment during ERC is LCA, followed by LCA. Attention should be paid to the integrity of marginal arteries and veins in the patients with history of epigastric operation.

A Case of Ruptured Aneurysm of the Accessory Middle Colic Artery

A Case of Ruptured Aneurysm of the Accessory Middle Colic Artery

Yenidoğanda A.Mesenterica Superior’un Kolonu Besleyen Dalları Ve Varyasyonları

The branches and variations of the superior mesenteric artery blood supplying for the colon in the newborn infants ✓ The branches of the superior mesenteric artery which blood supplies for the colon in the 46 fulterm newborn infants with normal birth weight were studied. The ileocolic artery was found out to be the least variable and to be existing all the time. In 10.8 percent of the cases, no right colic artery was seen. The a. colica media was observed to exist in all the cases. In 10.7 percent of the cases, the accessory middle colic artery was detected. The findings ob¬tained were compared with those in the literature. ✓ Normal dogum tartili ve miadinda 46 yenidoganda a. mesenterica superior (AMS)'un kolonu kanlandiran dallarini ve varyasyonlarini arastirmak amaciyla yapilan bu calismada a.ileocolica'nin daima bulunan ve en az degiskenlik gosteren arter oldugu saptandi. A.colica dextra'nm % 10.8 olguda bulunmadigi, a.colica media'nin tum olgularda varligi gozlendi. Olgu¬larin % 10.7'sinde ise, a.colica media accessoria'ya rastlandi. Elde edilen bulgular, literatur bulgulari isigi altinda degerlendirildi