回结肠动脉分支类型的观察

PATTERNS OF THE BRANCHES OF THE ILEOCOLIC ARTERY

回结肠动脉的分支类型,各种教科书上的记述,甚不一致。文献上仅见Anson等在观察了200例的基础上,分为9种类型[1],但他们的分型是以阑尾动脉的起始点为依据,故他们的材料,实际上是阑尾动脉起始点的类型,对回结肠动脉其他分支,并未完全顾到。Michels虽云观察了200例,但他的报告却只有一种一般的描述[2],证明他对回结肠动脉各分支,也未作仔细观察。

The author observed the ileocolic artery in 100 cadavers(41 adult males,14 fe-males,16 male and 21 female children,5 male and 3 female infants).The way of rami-??fication of this artery falls into seven types.In the first 6 types it divides into a superiorand an inferior branch,while in the last a middle branch is found in addition.Theyare described as follows:TypeⅠ.fhe superior is the colic branch and the inferior subdivides into cecal andileal branches(31.0±4.62%).TypeⅡ.The superior branch subdivides into colic and cecal branches,while theinferior is the ileal branch(7.0±2.55%).TypeⅢ.The superior branch is the anterior cecal branch while the inferior sub-divides into colic,ileal branches and cecal trunk(2.0±1.40%).TypeⅣ.The superior branch subdivides into colic,cecal and ileal branches whilethe inferior is the appendicular artery(7.0±2.55%).TypeⅤ.The superior and inferior branches anastomose with one another to formsingle or multiple irregular rings,from which the colic,cecal and ileal branches originate(15.0±3.57%).TypeⅥ.The colic,cecal and ileal branches arise from both the superior and in-ferior branches respectively(23.0±4.11%).TypeⅦ.The ileocolic artery divides into superior,middle,and inferior branches,the colic branch arises from the superior branch;the cecal branches arise from the superior,middle or the inferior branches;while the ileal branch from the middle or the inferiorbranch(15.0±3.57%).The appendicular artery may be single or double.Its origin varies greatly.Singleappendicular artery is observed in 83 cases(83.0±3.76%);in 12 cases it is one of theterminal branches of the ileocolic artery;in 3 cases it originates from the superior branch;in 15 cases from the inferior branch;18 cases from the cecal trunk,8 cases from theposterior cecal;8 cases from the arterial ring and 19 cases from the ileal branch.Double appendicular arteries are found in 17 cases(17.0±3.76%).The proximalbranch originates from the posterior cecal branch in 12 cases,from the anterior cecal in3 cases,from the ileal in 1 case and from the arterior ring in 1 case;the distal brancharises from the ileal branch in 10 cases,from ileocolic in 3 cases,from posterior cecalin 2 cases,from cecal trunk in 1 case and from the arterial ring in 1 case.Additional observations were made on the anastomoses between the branches of theileocolic artery,between the colic branch and the right colic artery and between the ilealbranch and the terminal branch of the superior mesenteric artery.Ⅰ.The appendicular artery does not anastomose with any other artery after it entersthe appendicular mesentery.Ⅱ.Only in 25 cases the cecal branch anastomoses with the colic branch by acommunicating vessel,which runs parallel with the wall of the intestine.Ⅲ.Anastomosis between the colic branch and the right colic occurs in all cases.In some cases the right colic artery is absent,the colic branch anastomoses with the mid-dle colic artery directly,but in 1 case it is very feeble.Ⅳ.Anastomosis between the ileal branch and the terminal branch of the superiormesenteric artery is complete and full.