[Occlusion of the three unpaired aortic branches with the development of an extensive Riolan's anastomosis (author's transl)]

Abstract

A 60-year-old patient with occlusion of the inferior and superior mesenteric arteries and the coeliac axis developed a collateral circulation from the iliac arteries through the rectal vessels, the ascending ramus of the inferior mesenteric artery and the medical colic branch of the superior mesenteric artery. These collaterals were able to ensure survival of all three vascular territories. Along the medial wall of the descending colon and the sigmoid a second, less well developed collateral circulation could be demonstrated by iliac arteriography. The branches of the superior mesenteric artery and of the coeliac axis were only partly demonstrated, or failed to fill, during a free aortic injection and a counter current arteriogram. Clinically the occlusion of the unpaired aortic branches manifested itself as periumbilical pain after food. The involvement of the visceral aortic branches to this extent in the presence of generalised vascular disease is related to an attack of dysentry 38 years previously.