The variant blood supply to the descending colon, rectosigmoid and rectum based on 400 dissections. Its importance in regional resections

The Pattern of Arrangements and Distributions of the Superior Mesenteric Artery in a Nigerian Population

“…The marginal arteries of the right colic and ileocolic arteries were not continuous in group C. This is similar to earlier workers who reported that the marginal artery may be discontinuous due to the ileocolic artery failing to anastomose with the right colic artery, and that the right colic artery very commonly may originate from the middle colic or ileocolic arteries (Steward & Rankin;Michels et al, 1963).…”

Anatomical considerations on Sudeck's critical point and its relevance to colorectal surgery

“…A number of studies have shown that there is in fact a macroscopic anastomosis between the SRA and last sigmoid artery. Michels et al (1965) found that the anastomosis between the last sigmoid artery and SRA was present in 39 of 75 specimens (52%). He took the study further and ligated 10 random specimens, from his sample (n = 75), distal to Sudeck's point, and injected a latex and India ink solution into the aorta.…”

“…Again the diagnosis was made during surgery, by means of endoscopy or a barium enema. Michels et al (1965) stated that their cadaveric dissection study and autopsy cases examined confirmed that openUP Sudeck's point existed from a gross anatomical point; however, experimental ligation studies, arteriograms, roentgenograms, and surgical procedures deny its functional importance.…”

“…On the other hand, many authors (Griffiths, 1956(Griffiths, , 1961Michels et al, 1965Michels et al, , 1968 believe that Sudeck's point is not at all critical. They argue that Sudeck's experimental technique was not always reliable, because it did not take into account that the arteries do not always fill up with fluid properly because of postmortem spasm.…”

“…The colonic blood supply contains various weak points known as watershed areas (Siddharth and Ravo, 1988), such as Griffiths' pointat the splenic flexure (Griffith, 1956;Michels et al, 1965Michels et al, , 1968Siddharth and Ravo, 1988;Yamazaki et al, 1997b) and Sudeck's point (Sudeck, 1907;Griffith, 1956;Michels et al, 1965Michels et al, , 1968Siddharth and Ravo, 1988;Yamazaki et al, 1997b) at the rectosigmoid junction. Therefore, ligation of the IMA proximal or distal to Sudeck's point, during resection of the sigmoid colon, can be crucial in terms of postoperative blood supply to the caudal stump, depending on whether the anastomosis between the superior rectal artery (SRA) and the last sigmoid branch is present, and sufficient to meet the demandsof the caudal stump.…”