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Mesenteric angiography 2010-2012

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Mesenteric angiography 2010-2012

  1. 1. Mesenteric Angiography Dustin Thompson MD PGY 4
  2. 2. Mesenteric Angiography •Commonly performed in patients with signs of lower gastrointestinal bleeding such as melena •Often preceded by a non-invasive nuclear medicine tagged red blood cell scan to confirm active bleeding •Allows diagnosis and immediate intervention through the use of intravascular embolic agents
  3. 3. Mesenteric Angiography •Access the arterial system via the right common femoral artery •Catheter is advanced through the common femoral, external iliac, common iliac, into the aorta •Tip of the catheter placed into the celiac trunk, superior mesenteric artery, and inferior mesenteric artery for contrast injection to search for bleeding
  4. 4. Celiac Trunk Native Image
  5. 5. Celiac Trunk Digitally Subtracted Angiogram
  6. 6. Celiac Trunk Branches Proper Hepatic Right and Left Hepatic Gastroduodenal Left Gastric Common Hepatic Splenic Catheter tip in the Celiac Trunk
  7. 7. Celiac Trunk Branches Right and Left Hepatic Proper Hepatic Left Gastric Gastroduodenal Common Hepatic Splenic Right Gastroepiploic Right Gastric
  8. 8. Celiac Trunk Injection
  9. 9. Superior Mesenteric Artery Native Image
  10. 10. Superior Mesenteric Artery Digitally Subtracted Angiogram
  11. 11. Superior Mesenteric Artery Branches SMA Middle Colic Right Colic Ileocolic Jejunal Branches Ileal Branches
  12. 12. Superior Mesenteric Artery Injection
  13. 13. Inferior Mesenteric Artery Digitally Subtracted Angiogram
  14. 14. Inferior Mesenteric Artery Branches IMA Left Colic Superior Hemorrhoidal Marginal Artery of Drummond Sigmoid Branches
  15. 15. Inferior Mesenteric Artery Injection
  16. 16. Anastomoses •Celiac Trunk –Supplies the spleen, stomach, liver, gallbladder and pancreas –Anastomosis to the SMA via gastroduodenal, superior pancreaticoduodenal branches
  17. 17. Anastomoses •Superior Mesenteric Artery –Supplies the pancreas, duodenum, small intestine, cecum, ascending colon, and proximal half of the transverse colon –Anastomosis to the IMA via middle colic to left colic
  18. 18. Anastomoses • Inferior Mesenteric Artery –Supplies the descending colon, sigmoid colon and rectum –Anastomosis to the distal aorta via superior hemorrhoidal, middle and inferior hemorrhoidal to the internal iliac artery
  19. 19. Thank You! •Any questions or comments please send to dustin.thompson.md@gmail.com

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