[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Abdomen](https://durgical.com/en/anatomy/region/abdomen/) › Mesenteric and aortic plexuses [Nervous system](https://durgical.com/en/anatomy/system/nervous-system/) · [Abdomen](https://durgical.com/en/anatomy/region/abdomen/) # Mesenteric and aortic plexuses The mesenteric plexuses are nerve networks on the aorta that follow its arteries to the intestines; they explain why early appendicitis hurts around the navel. Official name: Superior mesenteric plexus [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=abdomen&select=mesenteric_plexuses&side=r) Opens in the Durgical app, no sign-up needed. ## What it is Autonomic nerve networks around the superior mesenteric artery and along the aorta. ## What it does Control the movement and secretions of the intestines. ## Key points - A continuous chain on the aorta: celiac, superior mesenteric, intermesenteric (aortic), inferior mesenteric, then the superior hypogastric plexus; each follows its artery to its organs - Midgut pain is felt around the umbilicus: early appendicitis starts there before moving to the right iliac fossa when the parietal [peritoneum](https://durgical.com/en/anatomy/peritoneum/) is irritated - Pancreatic cancer often invades the nerve plexus around the superior mesenteric artery, which drives pain and limits surgical removal ## Key facts **Roots** Superior mesenteric: lesser and least splanchnics (T10–T12) and vagus; intermesenteric/aortic and inferior mesenteric: lumbar splanchnics (L1–L2) **Moves** Sympathetic vasoconstriction and inhibition of gut motility; parasympathetic (vagus to midgut, pelvic splanchnics S2–S4 to hindgut) increases it **Feeling from** Visceral pain: midgut referred to periumbilical region (T10), hindgut to hypogastrium (L1) ## Relations **Course** From the [celiac plexus](https://durgical.com/en/anatomy/coeliac-plexus-and-ganglia/) down the front and sides of the [abdominal aorta](https://durgical.com/en/anatomy/abdominal-aorta/), thickening around the superior and [inferior mesenteric artery](https://durgical.com/en/anatomy/inferior-mesenteric-artery/) origins, to the aortic bifurcation where it becomes the [superior hypogastric plexus](https://durgical.com/en/anatomy/superior-hypogastric-plexus/) **In front** [Pancreas](https://durgical.com/en/anatomy/pancreas/) and the root of the small-bowel mesentery; the third part of the [duodenum](https://durgical.com/en/anatomy/duodenum/) crosses in front of the aorta below the [superior mesenteric artery](https://durgical.com/en/anatomy/superior-mesenteric-artery/) **Behind** Abdominal aorta and the lumbar vertebral bodies **Lateral** Lumbar sympathetic trunks, which send lumbar [splanchnic nerves](https://durgical.com/en/anatomy/greater-thoracic-splanchnic-nerve/) into it; the [inferior vena cava](https://durgical.com/en/anatomy/inferior-vena-cava/) on the right **Below** The superior hypogastric plexus below the aortic bifurcation ## How to find it Seen in surgery as a web of fine nerve strands on the front of the aorta once the posterior peritoneum is opened, and as a dense nerve sheath around the origin of the superior mesenteric artery. ## On imaging Autonomic nerve networks are not seen on imaging. They surround the origins of the superior and inferior mesenteric arteries, so these vessels are the landmarks on CT and ultrasound. Their importance on imaging is indirect: CT shows a tumor, especially pancreatic cancer, encasing the mesenteric arteries or spreading along the soft tissue around them, which helps decide whether it can be removed. ## Common problems - Pain from pancreatic cancer can be eased by blocking it with an injection (celiac plexus block). ## Clinical notes - Retroperitoneal lymph node dissection for testicular cancer can cut these fibres and cause loss of ejaculation; nerve-sparing techniques preserve them - High ligation of the inferior mesenteric artery in rectal cancer surgery puts the inferior mesenteric plexus and the hypogastric nerves at risk, with sexual and urinary dysfunction - Perineural spread of pancreatic cancer along the superior mesenteric plexus is assessed on CT before surgery - Hindgut pain is felt above the pubis (hypogastrium) ## Related conditions - [Irritable bowel syndrome](https://durgical.com/en/conditions/irritable-bowel-syndrome/) ## Test yourself Think of the answer, then tap the question to see it. ## In what order do the autonomic plexuses run down the abdominal aorta? Celiac, superior mesenteric, intermesenteric (aortic), inferior mesenteric, then the superior hypogastric plexus below the aortic bifurcation. ## Why does early appendicitis cause pain around the umbilicus? Midgut visceral pain is referred to the periumbilical region (T10); the pain moves to the right iliac fossa once the parietal peritoneum is irritated. ## What can retroperitoneal lymph node dissection for testicular cancer do to these plexuses? Cut their fibres, causing loss of ejaculation; nerve-sparing techniques preserve them. ## Why does invasion of the superior mesenteric plexus matter in pancreatic cancer? Spread along the nerve plexus around the superior mesenteric artery drives pain and limits surgical removal. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/superior-mesenteric-plexus/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** plexus mesentericus superior; plexus intermesentericus; plexus aorticus abdominalis TA2 6705 **Official Spanish (DeCS)** Plexos mesentérico superior, intermesentérico y aórtico abdominal **English (TA2)** Superior mesenteric plexus **Also called** plexus mesentericus cranialis Sources: Terminologia Anatomica (TA2); [Anatomy, Abdomen and Pelvis, Splanchnic Nerves](https://www.ncbi.nlm.nih.gov/books/NBK560504/); [Anatomy, Abdomen and Pelvis, Nerves](https://www.ncbi.nlm.nih.gov/books/NBK542245/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/superior-mesenteric-plexus/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/superior-mesenteric-plexus/