Abe Tamami, Ujiie Ayako, Taguchi Yuya, Satoh Shun, Shibuya Takahiro, Jun Yan, Isogai Sumio, Satoh Yoh-Ichi
Department of Anatomy, Iwate Medical University School of Medicine, Morioka, Iwate, Japan.
Anat Sci Int. 2018 Jan;93(1):144-148. doi: 10.1007/s12565-017-0401-2. Epub 2017 Apr 6.
We have encountered in our anatomical practice the first case and an extremely rare second case in which the ascending, transverse, descending, and sigmoid colons were supplied by the inferior mesenteric artery. The causes of colic artery anomalies are generally explained in conjunction with the development of the superior mesenteric artery, which is intimately related to embryonic elongation and midgut rotation. However, this embryological model was inapplicable to both cases. This difficulty motivated us to seek possible relationships with reported anomalous inferior mesenteric arteries in adults as well as their embryological causes. We consider that the aberrant right colic artery found in 2009 is an "intermesenteric artery" which anastomoses the superior (or its middle colic branch) and inferior mesenteric artery, but secondarily lost its origin from the superior mesenteric artery. The aberrant colic artery found in 2010 is a "middle-inferior mesenteric artery" in which the inferior mesenteric artery formed a common trunk with remnant middle mesenteric artery.
在解剖实践中，我们遇到了首例以及极为罕见的第二例病例，其中升结肠、横结肠、降结肠和乙状结肠均由肠系膜下动脉供血。结肠动脉异常的原因通常结合肠系膜上动脉的发育来解释，而肠系膜上动脉的发育与胚胎伸长和中肠旋转密切相关。然而，这种胚胎学模型并不适用于这两个病例。这一难题促使我们探寻与已报道的成人肠系膜下动脉异常及其胚胎学原因之间可能存在的关系。我们认为，2009年发现的异常右结肠动脉是一条“肠系膜间动脉”，它将肠系膜上动脉（或其结肠中动脉分支）与肠系膜下动脉吻合，但随后失去了来自肠系膜上动脉的起源。2010年发现的异常结肠动脉是一条“肠系膜中下动脉”，其中肠系膜下动脉与残留的肠系膜中动脉形成了一个共同主干。
