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Critical Care Focus 9: The Gut - part 6

Lưu lượng máu đến các cơ quan nội tạng có nguồn gốc từ ba thân chính động mạch, động mạch celiac, các động mạch mạc treo cấp trên và các động mạch mạc treo tràng kém. Celiac động mạch cung cấp máu đến dạ dày và tá tràng | MESENTERIC ISCHAEMIA manifestations are varied depending on the site of vascular occlusion and the extent of the resulting bowel necrosis. Mesenteric vasculature The blood flow to the splanchnic organs is derived from three main arterial trunks the coeliac artery the superior mesenteric artery and the inferior mesenteric artery. The coeliac artery supplies blood to the stomach and duodenum the superior mesenteric artery supplies blood to the gut from the duodenum to the transverse colon and the inferior mesenteric artery is responsible for blood supply to the colon from the transverse colon to the rectum. Each of these three arterial trunks supplies blood flow to its specific section of the gastrointestinal tract through a vast network Figure 5.1 . Coeliac axis Right colon Superior mesenteric artery Middle colic artery Arch of Riolan Left colon Small intestine Internal iliac artery Inferior mesenteric artery Pancreaticoduodenal artery Figure 5.1 Schematic representation of the splanchnic circulation. Marginal artery Since blood can reach a specific segment of gut via more than one route this provides an effective protection against ischaemia and additional vascular protection is obtained from connections between the three arterial systems. Communication between the coeliac system and the superior mesenteric system generally occurs via the superior pancreaticoduodenal and the inferior pancreaticoduodenal arteries. The superior mesenteric and inferior mesenteric systems are joined by the arch of Riolan and the marginal artery of Drummond vessels that connect the middle colic artery a branch of the superior mesenteric artery and the left colic artery a branch of the inferior mesenteric artery . In addition communication also 43 CRITICAL CARE FOCUS THE GUT exists between the inferior mesenteric artery and branches of the internal iliac arteries via the rectum. In chronic vascular insufficiency blood flow to an individual system can be maintained through these .