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Surgical and Radiologic Anatomy

, Volume 41, Issue 3, pp 255–264 | Cite as

Inter-mesenteric connections between the superior and inferior mesenteric arteries for left colonic vascularization: implications for colorectal surgery

  • M. Bruzzi
  • L. M’harzi
  • S. El Batti
  • R. Abou Ghazaleh
  • J. Taieb
  • T. Poghosyan
  • A. Berger
  • J. M. Chevallier
  • R. DouardEmail author
Review
  • 49 Downloads

Abstract

Purpose

There is confusion regarding the names, the number, and the exact location of the colonic arterial arches which provide connections between the superior and inferior (IMA) mesenteric arteries at the level of the left colic angle. The aim of this review was to delineate the “true” colic arches arising in the meso of the left colic angle and to describe their surgical implications.

Methods

A systematic review of the literature was performed using the MEDLINE database. The search included only human studies between 1913 and 2018. All dissection, angiographic, arterial cast and corrosion studies were analyzed.

Results

The terms “Riolan arch”, “marginal artery of Drummond”, “meandering mesenteric artery” and “Villemin’s arch” must no longer be used in the scientific literature. Three arterial arches were found at the level of the left colic angle, permitting the communication between the two arterial mesenteric systems: (1) the Marginal Artery (the most peripheral, found in 100% of cases); (2) the “V” termination of the ascending branch of the left colic artery (LCA), existing in more than 2/3 of cases; and (3) the inter-mesenteric trunk, found more centrally located and existing in less than 1/3 of cases.

Conclusions

Three arterial arches exist at the level of the left colic angle: (1) the Marginal Artery, (2) the “V” termination of the ascending branch of the LCA, and (3) the inter-mesenteric trunk. The knowledge of this anatomy is essential for performing colorectal surgeries involving ligation of the IMA.

Keywords

Colic vascularization Colic arches Riolans’s arch Marginal artery Left colic angle 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Research involving human participants and/or animals

All applicable institutional and/or national guidelines were followed.

Informed consent

Informed consent does not apply.

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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  1. 1.URDIA Anatomie (EA4465)Paris Descartes Faculty of MedicineParisFrance
  2. 2.INSERM 970, Équipe 2, PARCC, HEGPParisFrance
  3. 3.General and Digestive Surgery UnitGeorges Pompidou AP-HP University HospitalParis Cedex 15France
  4. 4.Paris Descartes Faculty of MedicineParisFrance
  5. 5.Digestive Oncology UnitGeorges Pompidou AP-HP University HospitalParisFrance

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