Pancreaticoduodenal artery

Bertelli E, Di Gregorio F, Bertelli L, Civeli L, Mosca S (1996b) The arterial blood supply of the pancreas a review. III. The inferior pancreaticoduodenal artery. An anatomical review and a radiological study. Surg Radiol Anat 18 67-74... 

The duodenum is supplied by the pancreaticoduodenal arteries, consisting of two, sometimes three or more trunks bridging the gastroduodenal and superior mesenteric artery. One pancreaticoduodenal arcade is located anteriorly (mostly as a continuation of the gastroduodenal artery) and one posteriorly, with multiple anastomoses between them and other pancreatic arteries, building a rich collateral plexus (Fig. 5.4). 

Yamaguchi H, Wakiguchi S, Murakami G (2001) Blood supply to the duodenal papilla and the communicating artery between the anterior and posterior pancreaticoduodenal arterial arcades. J Hepato Biliary Pancreatic Surg... 

Rapid intravenous injections of natural caerulein at doses as low as 1-4 ng/kg increase blood flow through the caudal pancreaticoduodenal artery in absence of any change of other cardiovascular parameters. Larger doses of caerulein up to 40 ng/kg produced a further marked increase of blood flow together with a decrease of total femoral flow. The vasodilating effect on pancreaticoduodenal vessels reached its maximal value rather slowly 30-50 seconds and lasted 2-15 minutes. No action on other vascular beds... 

The superior mesenteric artery (SMA) has its origin approximately 1 cm inferior to the coeliac axis on the anterior aspect of the aorta. Its inferior pancreaticoduodenal branches anastomose with the superior pancreaticoduodenal artery to supply the mid and distal duodenum. 

Visceral aneurysms are uncommon and most frequently involve the splenic artery. They may also arise from the pancreaticoduodenal branches of either the GDA or SMA and the left gastric artery (Fig. 14.3). Although an underlying cause may not he demonstrated, many of these are associated with acute or chronic pancreatitis or are secondary to atheromatous disease. Atheromatous stenosis of the coeliac axis or compression of the coeliac axis by the median arcuate ligament of the diaphragm results in hypertrophy of the pancreaticoduodenal arteries and is associated with aneurysm formation. 

Fig.7.3a,b. A 53-year-old man after simultaneous pancreas-kidney transplantation. (CIA Common iliac artery, d donor s, ElA external iliac artery, llA internal iliac artery, IPDA inferior pancreaticoduodenal artery, r right, RA renal artery, RV renal vein, SA splenic artery, SMA superior mesenteric artery), a Angiogram obtained 31 months after operation shows normal posttransplant arterial anatomy with right-sided pancreatic and left-sided renal graft, b Maximum-intensity-projection reconstruction of contrast-enhanced MR imaging obtained 47 months after operation with normal posttransplant arterial anatomy... 

Fig. 7.14a,b. A 43-year-old woman with abdominal discomfort image obtained 12 days after simultaneous pancreas-kidney transplantation, a, b Contrast-enhanced multidetector CT displays acute thrombosis of superior mesenteric vein (arrowheads) and splenic vein (arrowhead) but homogeneous contrast enhancement of pancreatic graft (arrow) with donor s duodenum (arrows) and renal graft (asterisk). (CIA common iliac artery, CIV common iliac vein, d donor s, IPDA inferior pancreaticoduodenal artery, / left, r right, SA splenic artery, SMA superior mesenteric artery)... 

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