Case

A 53 year old patient undergoes a CT angiogram for a suspected aortic aneurysm. An incidental finding shows an embolic clot has broken free and completely blocked the right colic artery. However, the patient is exhibiting no symptoms.

Question 3/3 - Which artery(s) now principally supplying the ascending colon via the marginal artery?

Click on your selected option(s) below  (correct = 2, over-thinking = 3+)

Incorrect. All small intestine regions of jejunum to ileum are supplied by intestinal branches (from 15-20 branches). While some blood might shunt laterally to the cecum, these are more distant and not the principle ascending colon supply in this situation.  

Correct! The ileocolic artery supplies the cecum region. In the absence of the right colic supply, ileocolic artery blood will shunt via the marginal artery superiorly to supply parts of the ascending colon.  

Correct! The middle colic artery supplies the transverse colon. In the absence of the right colic supply, middle colic artery blood will shunt via the marginal artery around the right colic flexure (hepatic flexure) to supply parts of the ascending colon.  

Incorrect. The left colic artery supplies the descending colon which is too distant to effectively shunt blood around to the ascending colon.

Incorrect.  The gastroduodenal artery supplies duodenum, pancreas and stomach via further branching. This is also a foregut artery while the right colic is midgut territory.