[Collateral Circulation of the Left Colon: Historic Considerations and Actual Clinical Significance]
Overview
Affiliations
Introduction: The arterial communication between the superior and inferior mesenteric arteries is important in surgery of the colon and aorta.
Methods: The anastomosis between the median colic artery (ACM) and the superior colic artery (AMS) was studied on 52 cadavers (32 female, 20 male). The length of the artery was measured using a flexible scale, and its diameter was determined at three different locations (origin, middle, end).
Results: The median lengths of the arteries were: 6.8 cm (range 3.9-9.7) for ACM, 12.2 cm (range 7-17.4) for ACS, and 23 cm (range 13.6-34.2) for margin artery. The median diameters were: 3.4 mm (range 2.7-4.1) for ACM, 3.1 mm (range 2.1-4.1) for ACS, and 2.7 mm (range 2-3.4) for margin artery. In 9.6% of the cadavers ( n=5), additional anastomoses between the AMS and inferior mesenteric arteries were proven. In 90.4% ( n=47), only margin arteries were found.
Summary: The low incidence of an additional communication (Riolan's arch) and possible additional impairment of the blood supply should be taken into account during operation.
Evaluation of characteristics of left-sided colorectal perfusion in elderly patients by angiography.
Zhang C, Li A, Luo T, Li Y, Li F, Li J World J Gastroenterol. 2020; 26(24):3484-3494.
PMID: 32655271 PMC: 7327791. DOI: 10.3748/wjg.v26.i24.3484.
Dregelid E, Daryapeyma A Case Rep Vasc Med. 2013; 2013:978625.
PMID: 23476885 PMC: 3588210. DOI: 10.1155/2013/978625.
Bridging the gap with an ileocolonic graft after extensive colorectal resections.
Dauser B, Riss S, Stopfer J, Herbst F World J Surg. 2011; 36(1):186-91.
PMID: 22072431 DOI: 10.1007/s00268-011-1337-7.
Ferrari R, De Cecco C, Iafrate F, Paolantonio P, Rengo M, Laghi A Radiol Med. 2007; 112(7):988-98.
PMID: 17952680 DOI: 10.1007/s11547-007-0200-2.