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3D relations between right colon arteries and the superior mesenteric vein: a preliminary study with multidetector computed tomography

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Abstract

Background

3-D relations between the ileocolic (ICA), right colic artery (RCA) with the superior mesenteric vein (SMV) have been described in cadavers. However, no data exists on preoperative evaluation of these relations.

Aim

To define the length of crossing and 3-D position of the ICA and RCA to the SMV in patients undergoing multidetector computerized tomography (MDCT) angiography.

Methods

MDCT angiographies were analyzed with the aid of Osirix v.3.0.2. image processing application. All the datasets included arterial and venous phase, undergoing multimodal visualization: 2D multiplanar reconstruction with maximum intensity projection and 3D Volume rendering. The anatomical relations were analyzed in various planes (orthogonal and oblique), depending upon their particular course. When a clear spatial reference was achieved, the distance of the colic artery from their origin on the aorta to the right border of the SMV was measured, and its position noted.

Results

50 MDCT were analyzed (29 male). RCA occurred in 27 patients (54.0%), 25 (92.6%) passed anterior to the SMV. Length of crossing was 22.7 ± 8.1 (8.3–41.3) mm. The ICA occurred in 48 (96%) passing under the SMV in 38 (79.2%). Length of crossing 15.4 ± 5.8 (14.0–26.6) mm.

Conclusions

RCA occurs in 54% patients, passes over the SMV in 92.6% specimens and leaves a 22.7 mm stump. ICA passes under the SMV in most cases, leaving a 15.4 mm stump. These data could be of crucial importance to the surgeon facing laparoscopic right colectomy for cancer.

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Disclosures

Drs. Milan Spasojevic, Bojan Stimec, Jean Fasel, Sylvain Terraz, and Dejan Ignjatovic have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Gastrointestinal surgery, Vestfold Hospital, P.O. Box 2168, 3103, Tonsberg, Norway

    M. Spasojevic & D. Ignjatovic

  2. Anatomy Section, Department of Cellular Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva, Switzerland

    B. V. Stimec & J. F. Fasel

  3. Department of Radiology, University Hospitals of Geneva, Geneva, Switzerland

    S. Terraz

Authors
  1. M. Spasojevic
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  2. B. V. Stimec
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  3. J. F. Fasel
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  4. S. Terraz
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  5. D. Ignjatovic
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Corresponding author

Correspondence to D. Ignjatovic.

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Spasojevic, M., Stimec, B.V., Fasel, J.F. et al. 3D relations between right colon arteries and the superior mesenteric vein: a preliminary study with multidetector computed tomography. Surg Endosc 25, 1883–1886 (2011). https://doi.org/10.1007/s00464-010-1480-5

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  • DOI: https://doi.org/10.1007/s00464-010-1480-5

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