Middle Suprarenal Artery

arteria suprarenalis media

The middle suprarenal artery arises directly from the abdominal aorta at the level of the superior mesenteric artery origin, one on each side, to supply the central portion of the adrenal gland. The adrenal gland receives a triplicate blood supply: superior suprarenal arteries (from inferior phrenic), middle suprarenal arteries (from aorta), and inferior suprarenal arteries (from renal artery). All three contribute to an extensive adrenal cortical-medullary vascular plexus.

Region: Abdomen

Clinical Relevance

Clinical Notes

The rich triplicate suprarenal arterial supply means that adrenal preservation during neighbouring vascular or renal surgery is typically maintained by at least two of the three arterial sources. In adrenalectomy, the main adrenal vein is divided first (right adrenal vein drains to IVC, left to renal vein) followed by systematic arterial ligation. The middle suprarenal arteries are the most variable and are commonly secured last. In trauma with adrenal haematoma, the rich blood supply explains the large haematoma that can form within the adrenal gland after direct blunt injury.

Pathology

Common Injuries & Conditions

Adrenal Haematoma from Middle Suprarenal Artery Injury

Blunt abdominal trauma ruptures the middle suprarenal artery within the adrenal capsule, producing an adrenal haematoma visible as a high-density adrenal mass on CT; most are managed conservatively with serial imaging and monitoring for adrenal insufficiency, as the rich alternative arterial supply prevents total infarction in unilateral injury.