Doctor’s Passport

Find your next topic

Explore the current textbook

Available drafts · Clinical review pending
Membership
Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
RapidMRCPMRCS

Abdominal viscera and vascular supply

Essential points for quick revision.

Saved on this device

Synopsis

Link foregut, midgut and hindgut territories to arterial, venous, lymphatic and autonomic routes, then apply those maps to visceral relations and collateral pathways.

  • The coeliac trunk supplies foregut-derived organs through left gastric, splenic and common hepatic branches; the superior mesenteric artery supplies midgut and the inferior mesenteric artery hindgut.
  • Watershed labels describe border territories between arterial systems, but actual perfusion depends on arcades, marginal vessels, pressure and anatomical variation.
  • Portal venous blood from abdominal gut and spleen passes to liver before systemic return; the portal vein forms behind the pancreatic neck from superior mesenteric and splenic veins.

Reasoning priorities

01
Territory derivation

Assign a supplied gut segment to the most likely unpaired arterial system.

Use embryological boundary and named branch, then check overlap and anastomoses instead of treating the border as a sharp avascular line.

Worked reasoning

Worked caseLocalise an intestinal vascular territory

A supplied angiographic diagram shows reduced flow in a vessel arising anteriorly from the aorta at L1 and passing behind the pancreatic neck before crossing the third duodenal part; affected bowel extends from distal duodenum to proximal transverse colon.

  1. Use the aortic level and retro-pancreatic origin to identify the superior mesenteric artery rather than the coeliac trunk or IMA.
  2. Check the supplied bowel range against midgut derivatives: distal duodenum, jejunum, ileum, caecum, ascending colon and proximal transverse colon.
  3. Relate the vessel to the superior mesenteric vein on its right and to the pancreatic/duodenal structures that overlie or underlie its course.
  4. Conclude that the diagram represents an SMA/midgut territory; do not infer the cause or reversibility of reduced flow from anatomy alone.
  5. Verify by tracing jejunal/ileal and colic branches and checking whether collateral pathways shown are truly connected and patent.
Open full textbook Answer 2 questions
Sources and review status8 sources · checked 7 Sept 2026 · clinical review pending
Sources

Sources and review status

National guidance is shown before implementation-dependent detail. Apply principles in context and verify current guidance when a decision affects care. Source check completed 7 Sept 2026; clinical approval remains outstanding.

Authoring stateRapid draftClinical stateAwaiting reviewJurisdictionUnited Kingdom