The short gastric arteries are four to six small arteries from the splenic artery and its terminal branches passing in the gastrosplenic ligament to supply the gastric fundus. They are the most superior gastric blood supply and anastomose with branches of the left gastric artery on the lesser curvature and with the left gastroepiploic artery inferiorly, completing the submucosal gastric arterial network.
Division of the short gastric arteries is required during total gastrectomy, fundoplication (Nissen procedure requiring gastric fundus mobilisation for wrap), sleeve gastrectomy, and laparoscopic splenectomy. In Nissen fundoplication, inadequate short gastric vessel division results in a tense posterior wrap causing dysphagia. After splenectomy, the gastric fundus loses its short gastric supply and may develop gastric wall necrosis at the fundus if additional ischaemia is superimposed by left gastric artery compromise.
Loss of the short gastric arteries after splenectomy, combined with division of the left gastroepiploic, devascularises the gastric fundus and can cause fundal ischaemia and necrosis particularly when the left gastric artery is also compromised by splenic artery ligation for bleeding control.
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