The inferior pancreaticoduodenal artery is the first branch of the superior mesenteric artery, arising just below the pancreatic neck and dividing into anterior and inferior branches that run in the groove between the pancreatic head and duodenum. It anastomoses with the superior pancreaticoduodenal artery branches from the gastroduodenal artery, creating the pancreaticoduodenal arterial arcade.
| Origin | Superior mesenteric artery (or the first jejunal artery) at the upper border of the third part of the duodenum |
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| Course | Runs to the right and divides into anterior and posterior branches that ascend between the pancreatic head and the duodenum to join the superior pancreaticoduodenal arteries |
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The inferior pancreaticoduodenal artery is the SMA branch most at risk during SMA embolectomy, bypass procedures for chronic mesenteric ischaemia, and SMA thrombosis. Acute SMA occlusion proximal to the IPDA produces pancreatitis-like ischaemia of the pancreatic head alongside small bowel infarction. During pancreaticoduodenectomy, the IPDA is divided from the SMA side to free the uncinate process; unrecognised SMA injury at this division step is a catastrophic complication.
Division of the inferior pancreaticoduodenal artery from the SMA during pancreaticoduodenectomy uncinate process dissection requires careful identification of the SMA trunk to prevent inadvertent SMA injury in an area obscured by the portal vein and mesenteric vein that must be lifted anteriorly.
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