The meandering mesenteric artery: a historic review and surgical implications.
OBJECTIVE
The aim of this study was to review the literature regarding collateral mesenteric circulation with emphasis on the mesenteric meandering artery (of Moskowitz). Standard vascular embryology and anatomy are described as are the collateral mesenteric vessels that can develop with arterial stenosis or occlusion. A discussion on the correct usage of terms for describing mesenteric collateral vessels follows.


METHODS
We undertook review of the historical literature to discuss the surgical implications of the meandering mesenteric artery.


RESULTS
Despite a long history of study by anatomists and surgeons, confusion still persists regarding both the number and correct descriptive terminology of the collateral mesenteric vessels.


CONCLUSIONS
The use of the vague historic term "arc of Riolan" should be discarded for the more precise term "meandering mesenteric artery." The meandering mesenteric artery should routinely be preserved in all surgical procedures, to include resection for cancer, given its critical function in providing collateral mesenteric circulation. Further evaluation in the asymptomatic patient, however, is unnecessary.
Gourley
Eric J
EJ
Department of Surgery, General Surgery Service, William Beaumont Army Medical Center, El Paso, Texas 79920, USA. Ericjgourley@aol.com
Gering
Scott A
SA
D003097:Collateral Circulation; D005767:Gastrointestinal Diseases / Q000601:surgery*; D006801:Humans; D008638:Mesenteric Arteries / Q000033:anatomy & histology*; D013152:Splanchnic Circulation