The blood vessels of the jejunum and ileum: A comparative study of man and certain laboratory animals

Abstract

Tli c coinpara tivc aiia t om? of tlie small-int cst iiiol c~irculation lias received remarkaljlj-iittlc attentioii. Our interest in this sahject dates I'rom attempts to reproduce in the clog the <alinical picture seen in liuman mesentelk tlii*oml~osi> arid c~mbolisrn. Having: little success, aiid being imliresscd by the great power of rcvascularixati on shown by tlic dug, it occurred Aided hy grants from thc Coiiiliiittee on Scientific Rcscnrcl~ of the A n i e i i c~~~i ociation, the Tlicoclore A . McGrnnb"Und, :111d the M C G T P~O P l~hiid 093 ~1 1~1 n i m r r A x JOT-RJAL OF WA'PO\IB T-UL 7 3 , N O ; h O \ E:xlILII I'L1 :These finrlings we cannot confiriii e w q t in t h e dog: n e aic in agreement Ivlth Dnight ( '03) that t h e 11umaii v a s t recta dn not inteiroinn~uiiicatc during their c m r w f i oiri the peripheral arcades to tlic intestinal wall.' The p~essnrcs listed are avcmge and must be reduced somcwhnt in the caae of mialler aiiimals to a\ oitl ruptiirc of thc finer ve.;sels.Ethyl alcohol caiiiiot h e used becausc of its t?nrleiicy to remove sornc of thc pigment, cspeeiallv ttrc red, froiii ilrc iniectioii iiiaqses.

An investigation of human jejunal and ileal arteries

“…Whilst the number of jejunal and ileal branches from the SMA has been recorded by various techniques in the cadaver and in vivo (Beaton and Anson 1942;Cokkinis 1930;Noer 1943;Michels 1955;Nebesar et al 1969), anastomotic arcades and arteriae recta have rarely been analysed quantitatively, and there appear to be no data concerning their relative muscularity or elastin content. Anatomical and surgical reference texts simply refer to the calibre of the ileal arteries as being smaller than the jejunal (Chevrel 1995;Standring 2008) and the jejunum as having one or two tiers of anastomotic arcades compared to three to five in the ileum.…”

“…We also found a significantly greater number of AR in an equivalent length of ileum compared to the jejunum, and these ARs were significantly shorter and narrower. The shorter AR length in the ileum has been reported previously (Dwight 1903;Cokkinis 1930;Noer 1943), but the neat progressive diminution reported by Cokkinis (1930) was not evident. Further, we could only find one previous report comparing numbers of AR in the jejunum and ileum, and this related to a single cadaver specimen (Beaton and Anson 1942); these authors also found a greater density of AR in the ileum than the jejunum.…”

“…The gross anatomy of small bowel arteries has previously been investigated by a variety of methods including cadaver dissection (Beaton and Anson 1942;Michels 1955), in vivo angiography (Nebesar et al 1969) and post-mortem injection studies (Cokkinis 1930;Noer 1943). Jejunal and ileal arterial branches from the superior mesenteric artery (SMA) fan out within the small bowel mesentery and divide into two, each branch communicating with a branch from the artery above or below.…”

Alternative ileal flap for bladder augmentation if mesentery is short

“…According to the observation of Eisberg and Noer [9,10] it was expected that ligation of some VR may not alter microcirculation. Ligation of one VR did not alter the RBCV and PR significantly, either in the control or in the alternative flap (AD) groups.…”

“…Neighbouring VR have been reported to have communicating anastomoses, and ligation of some vessels may therefore not compromise microcirculation of the adjacent bowel segment [9,10].…”