Variant anatomy of the colonic and aberrant branches of the superior mesenteric artery

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Abstract

Background. The rapid development of abdominal, endovascular surgery and transplantology necessitate a detailed study of the structural features of the abdominal cavity vessels.

Aim. To study the variant anatomy of the colonic branches of the superior mesenteric artery in men and women.

Material and methods. The study was conducted based on the analysis of the results of multislice spiral computed tomography, a total of 2300 computed tomograms of adults aged 25 to 75 years (913 males and 1387 females) were studied. To assess the statistical significance of the aorta branches architectonics variants frequency dependence on gender, the method of analyzing four-field tables (Pearson's chi-square test) was used. The correlation strength was assessed using the normalized value of the Pearson coefficient.

Results. It has been established that the branches of the superior mesenteric artery, which vascularize the large intestine, have a wide range of variant anatomy. According to their number and the presence of aberrant branches, these variants can be classified into mono-, bi-, tri-, quadri- and penta-arterial. The most common variant of the architectonics of these branches of the superior mesenteric artery is biarterial. Mono- and pentaarterial branching variants of the colonic branches of the superior mesenteric artery are extremely rare in both sexes. The iliocolic and middle colic arteries are permanent branches of the superior mesenteric artery, and the right colic artery may be absent (in 7% of cases in males and 19% in females). Among the aberrant branches of the superior mesenteric artery, we noted the arteries involved in the blood supply to the liver: the right accessory, right replacement, and common hepatic arteries. In men in 25% of cases, in women in 16% of cases, a deviation from the superior mesenteric artery of the aberrant hepatic branch was noted.

Conclusion. The architecture of the colonic branches of the superior mesenteric artery is characterized by a wide range of variant anatomy and a high incidence of aberrant hepatic arteries.

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About the authors

Ivan V. Gaivoronsky

Military Medical Academy named after S.M. Kirov; St. Petersburg State University

Email: i.v.gaivoronsky@mail.ru
ORCID iD: 0000-0002-7232-6419

M.D., D. Sci. (Med.), Prof., Head of Depart., Depart. of Normal Anatomy; Head., Depart. of Morphology, St.-Petersburg State University

Russian Federation, St. Petersburg, Russia; St. Petersburg, Russia

Petr M. Bykov

Belgorod State National Research University

Email: bpm.aibolit@mail.ru
ORCID iD: 0000-0003-3462-456X

Sen. Lecturer, Depart. of Human Anatomy and Histology

Russian Federation, Belgorod, Russia

Maria G. Gaivoronskaya

St. Petersburg State University; National Medical Research Center named after V.A. Almazov

Author for correspondence.
Email: solnushko12@mail.ru
ORCID iD: 0000-0003-4992-9702

M.D., D. Sci. (Med.), Prof.; Assoc. Prof., Depart. of Morphology

Russian Federation, St. Petersburg, Russia; St. Petersburg, Russia

Georgy I. Sinenchenko

Military Medical Academy named after S.M. Kirov

Email: profsinenchenko@yandex.ru
ORCID iD: 0000-0001-5659-781X

M.D., D. Sci. (Med.), Prof., Depart. of General Surgery

Russian Federation, St. Petersburg, Russia

Gennady I. Nichiporuk

Military Medical Academy named after S.M. Kirov; St. Petersburg State University,

Email: nichiporuki120@mail.ru
ORCID iD: 0000-0001-5569-7325

M.D., Cand. Sci. (Med.), Assoc. Prof., Depart. of Normal Anatomy; Assoc. Prof., Department of Morphology

Russian Federation, St. Petersburg, Russia; St. Petersburg, Russia

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Supplementary files

Supplementary Files
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1. Рис. 1. Моноартериальный вариант ветвления толстокишечных ветвей верхней брыжеечной артерии (ВБА): СОА — средняя ободочная артерия; ПОА — подвздошно-ободочная артерия; ПрОА — правая ободочная артерия. Многосрезовая спиральная компьютерная томография, Volume Rendering

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2. Рис. 2. Биартериальный вариант архитектоники толстокишечных ветвей верхней брыжеечной артерия (ВБА): а — стволовой; б — простой; СОА — средняя ободочная артерия; ПОА — подвздошно-ободочная артерия; ПрОА — правая ободочная артерия. Многосрезовая спиральная компьютерная томография, Volume Rendering

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3. Рис. 3. Триартериальный вариант архитектоники толстокишечных ветвей верхней брыжеечной артерии (ВБА): а — простой; б — стволовой; СОА — средняя ободочная артерия; ПОА — подвздошно-ободочная артерия; ПрОА — правая ободочная артерия. Многосрезовая спиральная компьютерная томография, negMIP, коронарная плоскость

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4. Рис. 4. Квадриартериальный вариант ветвления толстокишечных ветвей верхней брыжеечной артерии (ВБА): СОА — средняя ободочная артерия; Доб. СОА — добавочная средняя ободочная артерия; ПОА — подвздошно-ободочная артерия; ПрОА — правая ободочная артерия. Многосрезовая спиральная компьютерная томография, Volume Rendering

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5. Рис. 5. Пентаартериальный вариант ветвления толстокишечных ветвей верхней брыжеечной артерии (ВБА): СОА — средняя ободочная артерия; Доб. СОА — добавочная средняя ободочная артерия; ПОА — подвздошно-ободочная артерия; ПрОА — правая ободочная артерия; Доб. ПрОА — добавочная правая ободочная артерия. Многосрезовая спиральная компьютерная томография, Volume Rendering

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6. Рис. 6. Вариант отхождения общей печёночной артерии от верхней брыжеечной артерии (ВБА): ОПА — общая печёночная артерия. Многосрезовая спиральная компьютерная томография, Volume Rendering

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