Cardiovascular Anatomy: Gastrointestinal Arteries

Overview

• Focus on gastrointestinal arteries divided into three components:
  • Foregut
  • Midgut
  • Hindgut

Arterial Supply of the GI Tract

Foregut

• Supplied by the Celiac Trunk
• Structures include:
  • Lower esophagus
  • Stomach
  • First part of the duodenum
• Branches of the Celiac Trunk:
  • Left gastric artery
  • Splenic artery
  • Common hepatic artery

Midgut

• Supplied by the Superior Mesenteric Artery (SMA)
• Structures include:
  • Small intestines
  • Ascending colon
  • Proximal two-thirds of the transverse colon

Hindgut

• Supplied by the Inferior Mesenteric Artery (IMA)
• Structures include:
  • Distal third of the transverse colon
  • Descending colon
  • Sigmoid colon
  • Rectum

Detailed Anatomy of Arterial Supply

Celiac Trunk

• Main branches:
  • Left gastric artery
  • Splenic artery
  • Common hepatic artery
• Common Hepatic Artery:
  • Becomes the hepatic artery proper
  • Part of the portal triad
  • Supplies the liver
• Gastroduodenal Artery: Risk of hemorrhage with posterior duodenal ulcers
• Splenic Artery:
  • Supplies the spleen
  • Short gastric artery: Supplies the fundus of the stomach
  • Left gastroepiploic artery: Anastomoses with right gastroepiploic artery

Superior Mesenteric Artery (SMA)

• Supplies midgut structures
• SMA Syndrome: Compression of the third part of the duodenum due to reduced fat pad
• Nutcracker Syndrome: Compression of the left renal vein by the SMA
• Acute Mesenteric Ischemia: Blockage causes ischemia in midgut structures

Inferior Mesenteric Artery (IMA)

• Supplies hindgut structures
• Less common site for ischemia compared to SMA

Clinical Implications

• Duodenal Ulcers:
  • Anterior ulcers more common
  • Posterior ulcers can cause hemorrhage due to gastroduodenal artery involvement
• Gastric Ulcers:
  • Typically occur on the lesser curvature
  • Involvement of left and right gastric arteries
• Ischemia:
  • SMA: More common in ischemic events
  • IMA: Rarely involved in ischemia

Key Points

• Understand the division of GI arterial supply into foregut, midgut, hindgut
• Recognize clinical significance of ulcer locations and potential artery involvement
• Familiarity with SMA and IMA-related conditions and syndromes
• Knowledge of arterial branches and their specific anatomical regions

These notes cover the essential points regarding the gastrointestinal arterial supply and associated anatomical and clinical considerations.