Blood supply to the stomach

Arterial system: main sources

The arterial supply to the stomach is based on the celiac trunk system (truncus celiacus). Key vessels include:

• Left gastric artery (a. gastrica sinistra): originates from the celiac trunk in 75% of cases, has a length of 3–7 cm and a diameter of 2–5 mm. It runs within the gastropancreatic ligament, gives off esophageal branches (rr. esophageales), and descends along the lesser curvature.
• Right gastric artery (a. gastrica dextra): typically arises from the proper hepatic artery, with a length of 2–5 cm and a smaller diameter (1–2 mm).
• Left gastroepiploic artery (a. gastroepiploica sinistra): a branch of the splenic artery running within the gastrosplenic ligament.
• Right gastroepiploic artery (a. gastroepiploica dextra): originates from the gastroduodenal artery and has a larger diameter (1.5–3.0 mm).
• Short gastric arteries (aa. gastricae breves): 1 to 6 branches of the splenic artery directed toward the fundus of the organ.

Arterial arcades of the curvatures

Along the curvatures of the stomach, vessels form prominent anastomoses:

1. Lesser curvature: forms a robust anastomotic arterial arcade created by branches of the left and right gastric arteries, from which direct branches depart to the organ walls.
2. Greater curvature: the arcade is formed by the junction of the right and left gastroepiploic arteries. It gives rise to branches supplying the stomach walls, as well as 4–8 right epiploic arteries.

Intra-organ bed and layers

Upon penetrating the wall of the organ, arterial and venous branches form ramified networks in various layers:

• Subserous network
• Intermuscular network
• Submucosal network
• Intramucosal network

The submucosal venous plexus is the most prominent, where large veins are arranged transversely relative to the axis of the organ and head toward its curvatures.

Venous outflow and clinical significance

Extra-organ veins mirror the course of the arteries, ensuring venous drainage:

• Left gastric vein (v. gastrica sinistra) most frequently drains into the portal vein.
• Right gastric vein (v. gastrica dextra) runs toward the portal vein or its left branch.
• Right gastroepiploic vein (v. gastroepiploica dextra) drains into the superior mesenteric vein.
• Left gastroepiploic vein (v. gastroepiploica sinistra) and short veins (vv. gastricae breves) carry blood into the splenic vein.

Clinical landmark: Mayo's pyloric vein lies on the anterior surface of the pylorus between the right gastroepiploic and right gastric veins, serving as a clear boundary between the pylorus and the duodenum. In the esophagogastric junction, venous networks participate in the formation of portosystemic anastomoses.

Briefly: answers to topical questions

Class and exam questions

What else to study on this topic

• Variants of the origin of the left gastric artery from the common hepatic artery or aorta
• Anatomic parameters of length and diameter of the right gastroepiploic artery
• Structure and function of the submucosal venous plexus in the esophagogastric region
• Topography of short gastric arteries and veins within the gastrosplenic ligament
• Features of portosystemic anastomosis formation at the gastric level

Other topics in the section "Topographic Anatomy of the Abdomen"

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