Superior Rectal Artery

arteria rectalis superior

The superior rectal artery is the primary rectal blood supply from the IMA. Its submucosal branches anastomose with the middle rectal (internal iliac) and inferior rectal (pudendal) arteries to form the rectal arterial plexus. In anterior resection for rectal cancer, the IMA is divided at its origin (high tie) or just below the left colic branch (low tie), transecting the superior rectal artery and relying on the middle rectal anastomosis for the anastomotic segment blood supply.

Region: Abdomen

Anatomical Data

Origin, Insertion & Supply

Origin	Inferior mesenteric artery (terminal branch)

Clinical Relevance

Clinical Notes

The SRA is divided in all rectal cancer resections — the adequacy of collateral supply from the middle rectal artery determines anastomotic healing. Colorectal surgeons assess the cut end of the bowel for pulsatile bleeding before anastomosis. Inadequate perfusion (no bleeding from the cut end) requires shortening the bowel to viable tissue before completing the anastomosis.

Pathology

Common Injuries & Conditions

Rectal Anastomotic Ischaemia

Inadequate SRA collateral supply after IMA ligation producing anastomotic ischaemia and leak — prevented by confirming bowel end perfusion before completing the anastomosis.