Cardiovascular system · Pelvis
Superior rectal artery !
The superior rectal artery is the end of the inferior mesenteric artery; it is the main blood supply of the upper and middle rectum.
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What it is
The end of the inferior mesenteric artery, running down behind the rectum.
What it does
The main blood supply of the upper and middle rectum.
Key facts
- Origin
- Continuation of the inferior mesenteric artery as it crosses the left common iliac vessels into the sigmoid mesocolon
- Branches
- Right and left branches at about S3 that run down and pierce the rectal wall; anastomose with the middle and inferior rectal arteries
- Supplies
- Upper and middle rectum and anal canal mucosa above the pectinate line; tied high with the mesorectum in rectal cancer surgery
Relations
- Course
- Continues the inferior mesenteric artery across the left common iliac vessels, descends in the root of the sigmoid mesocolon, then behind the rectum within the mesorectum before dividing
- Lateral
- Left ureter near the pelvic brim, at risk when the vessel is tied
- Behind
- Sacrum and the presacral fascia behind the mesorectum
- In front
- Rectum, whose wall its branches pierce
On imaging
CT angiography or catheter angiography shows it in lower gastrointestinal bleeding; its branches can be embolized for bleeding haemorrhoids.
Treatment
- Tied high in rectal cancer surgery, with the fatty tissue around the rectum (mesorectum).
Clinical notes
- Doppler-guided haemorrhoidal artery ligation ties its terminal branches above the pectinate line, where there is no pain sensation
- Sudeck point, between the last sigmoid artery and the superior rectal artery, is classically described as a weak link in collateral flow
- In rectal cancer surgery a high tie at the origin of the inferior mesenteric artery clears more nodes, while a low tie below the left colic artery keeps more flow to the colon used for the anastomosis; which is better is still debated
Development
As the end branch of the hindgut artery (inferior mesenteric) it supplies the bowel down to the pectinate line, the lower limit of the hindgut; below that line the anal canal is fed by the inferior rectal artery from the internal pudendal artery.
Test yourself
Think of the answer, then tap the question to see it.
Of which artery is the superior rectal artery the continuation?
The inferior mesenteric artery, as it crosses the left common iliac vessels into the sigmoid mesocolon.
Why do internal haemorrhoids bleed bright red and painlessly?
The superior rectal artery supplies the mucosa above the pectinate line, which has no pain sensation.
What are the classic haemorrhoid positions fed by the superior rectal artery?
Left lateral, right anterior and right posterior (3, 7 and 11 o'clock with the person on the back).
Why is the superior rectal artery tied at its origin in rectal cancer surgery?
So that the lymph nodes along it, the main path of spread, are removed with the mesorectum.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- arteria rectalis superior
- Official Spanish (DeCS)
- Arteria rectal superior
- English (TA2)
- Superior rectal artery
Related
Sources: Anatomy, Abdomen and Pelvis: Inferior Mesenteric Artery; Anatomy, Abdomen and Pelvis, Rectum; 23.5 The Small and Large Intestines (OpenStax (Rice University), 2022) · adapted, CC BY 4.0.
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Representative model, for educational purposes only.
