Superior Mesenteric Ganglion

ganglion mesentericum superius

The superior mesenteric ganglion is a prevertebral sympathetic ganglion lying at the origin of the superior mesenteric artery from the aorta, at the L1 level. It receives preganglionic fibres from the thoracic splanchnic nerves (lesser splanchnic nerve, T10-T11) and distributes postganglionic sympathetic fibres along the SMA and its branches to the small intestine and right colon. It is part of the celiac-mesenteric ganglionic complex.

Region: Abdomen

Clinical Relevance

Clinical Notes

The superior mesenteric ganglion is targeted in splanchnic nerve ablation procedures for visceral pain from pancreatic cancer and chronic pancreatitis. CT-guided or endoscopic ultrasound-guided celiac plexus blocks include the superior mesenteric ganglion in the injection volume. Ischaemia of the superior mesenteric ganglion territory is responsible for the severe midgut pain of SMA occlusion before intestinal infarction occurs. The ganglion is also relevant in the anatomy of the superior hypogastric plexus arising from it.

Pathology

Common Injuries & Conditions

Superior Mesenteric Ganglion in Celiac Plexus Block

Celiac plexus neurolysis for pancreatic cancer pain targets the celiac and superior mesenteric ganglia at the aortic level; CT-guided injection of absolute alcohol posterior to the aorta at the L1 level reaches both ganglia and provides visceral pain relief in 70-90% of patients for a median of 3 months.