Enlarged arc of Riolan and marginal artery of Drummond secondary to occluded celiac axis and superior mesenteric artery

Case contributed by Dr Chris O'Donnell

Presentation

Gross loss of weight over the last 2 years following complicated abdominal surgery. Marked ischaemic gastritis on endoscopy

Patient Data

Age: 45
Gender: Female

Occluded celiac axis and SMA at their origins (only tiny stumps are visible) with the IMA feeding enlarged arc of Riolan and wandering artery of Drummond (arrows) through to the SMA and its branches via the ileo-colic, and celiac axis branches via the inferior pancreatico-duodenal branches of the SMA into the pancreatico-duodenal branches of the common hepatic artery.

Case Discussion

Vascular anastomoses in the bowel are such that chronic occlusion can be compensated by hypertrophy of these anastomoses including Drummond and Riolan, such that in this case the IMA is supplying the entire blood supply to the bowel and upper abdominal organs.

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Case information

rID: 58090
Published: 31st Jan 2018
Last edited: 31st Jan 2018
System: Vascular
Inclusion in quiz mode: Included

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