In regard to the arterial blood supply to the stomach, which of the following statement(s) is/are true?
A. The right gastric artery, a branch of the superior mesenteric artery, supplies the gastric antrum
B. Because of rich intramural collaterals, gastric viability may be preserved after ligation of all
But one major artery
C. In cases of celiac artery occlusion, gastric viability is maintained collaterally via
pancreaticoduodenal arcades
D. The left gastroepiploic artery is a branch of the celiac trunk
E. All of above.
A. The right gastric artery, a branch of the superior mesenteric artery, supplies the gastric antrum
B. Because of rich intramural collaterals, gastric viability may be preserved after ligation of all
But one major artery
C. In cases of celiac artery occlusion, gastric viability is maintained collaterally via
pancreaticoduodenal arcades
D. The left gastroepiploic artery is a branch of the celiac trunk
E. All of above.
Ans. B, C. The stomach is an extremely
well-vascularized organ, supplied by 5 major arterial distributions and
protected from ischemia by rich intramural and extramural collaterals. The left
gastric artery and right gastric artery, derived from the celiac distribution,
supply the lesser curvature of the stomach. The right gastroepiploic artery,
derived from the gastroduodenal artery, and the left gastroepiploic artery,
from the splenic artery, traverse the greater curvature. The area adjacent to
the spleen receives multiple short gastric arterial branches. In instances of
celiac arterial occlusion, the superior mesenteric artery supplies the stomach
collaterally via the pancreaticoduodenal arcades which connect with the
gastroduodenal artery. The stomach may be widely mobilized for use in
reconstructive procedures, for example, during trans-hiatal esophagectomy.
Advantage is taken of the abundant blood supply and collaterals of the stomach
during mobilization; gastric viability is usually preserved if one major arterial
supply is preserved.
