Superior Mesenteric Artery (Full)

arteria mesenterica superior

The SMA supplies the midgut derivatives from the duodenum to the transverse colon. SMA occlusion from embolus (most common — 50%), thrombosis, or dissection produces acute mesenteric ischaemia — a surgical emergency with 60-80% mortality from bowel infarction. SMA syndrome from the narrow aorto-mesenteric angle compresses the third part of the duodenum, producing postprandial pain and weight loss.

Region: Abdomen

Anatomical Data

Origin, Insertion & Supply

Origin	Abdominal aorta at the L1 level (just below the coeliac trunk)

Clinical Relevance

Clinical Notes

Acute SMA embolism presents with sudden severe abdominal pain disproportionate to examination findings (pain out of proportion). CT angiography confirms the embolus at the SMA origin or at the takeoff of the middle colic artery (the most common site for large emboli to lodge). Emergency embolectomy or endovascular aspiration thrombectomy with bowel resection for non-viable segments is the management.

Pathology

Common Injuries & Conditions

Acute Mesenteric Ischaemia

SMA embolism producing midgut ischaemia managed with emergency endovascular or open embolectomy and bowel resection of non-viable segments.