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động mạch mạc treo tràng kém (L3), chia thành động mạch đau bụng cấp trên bên trái, động mạch đau bụng kém trái, và các động mạch cấp trên trực tràng. Ba cặp của các động mạch nội tạng bên: • thượng thận động mạch động mạch thận • động mạch sinh dục (tinh hoàn hoặc buồng trứng). | The renal tract retroperitoneum and pelvis ANDREA g. rockall and SARAH j. vinnicombe Liver Celiac axis Vertebrae Stomach Superior mesenteric artery Aorta Fig. 6.21. Longitudinal ultrasound scan through the aorta celiac and superior mesenteric arteries. inferior mesenteric artery at L3 dividing into the superior left colic artery inferior left colic arteries and the superior rectal artery. Three pairs of lateral visceral arteries adrenal arteries renal arteries gonadal arteries testicular or ovarian . Five pairs of lateral abdominal wall arteries inferior phrenic arteries supplying the diaphragm four pairs of lumbar arteries supplying the abdominal wall . Imaging the aorta Ultrasound The abdominal aorta may be imaged from the diaphragm to the bifurcation although occasionally the distal aorta is obscured by overlying bowel gas. It is normally 2-3 cm in diameter Fig. 6.21 . CT and MRI The aorta and its main branches are well depicted on CT and MRI following intravenous contrast enhancement Figs. 6.1 6.2 and 6.7 . The celiac axis superior mesenteric artery and renal arteries Left hepatic artery Intercostal artery Left gastric artery Hepatic artery Ileocolic artery Distal superior mesenteric artery Common hepatic artery Right renal artery Gastroduodenal artery Splenic artery Jejunal branches Lumbar arteries Left renal arteries 2 Superior mesenteric artery Fig. 6.22. Flush aortogram frontal projection. Note the left hepatic artery arises from the left gastric artery a variant seen in 25 of normal individuals . The patient has two left renal arteries. are always visible when normal. The inferior mesenteric artery and several lumbar arteries may also be seen. Multi-detector CT or MR angiography enable image reformatting to demonstrate the vessels in any anatomical plane. Angiography A pigtail catheter introduced into the upper abdominal aorta is used to inject iodinated contrast medium directly into the aorta followed by rapid imaging Fig. 6.22 . Selective catheterization