Jejunum and ileum
Organ supplied · Midgut T10–T11
Midgut small bowel from the duodenojejunal flexure to the ileocaecal valve, about 6 m long, supplied entirely by SMA arcades in the mesentery; the terminal ileum shares the ileocolic artery. Visceral pain travels with the lesser splanchnic nerves and is felt around the umbilicus.
Traced from the start
Detail
- Supply
- Jejunal and ileal arcades (SMA); terminal ileum via ileal branch of ileocolic
- Referred pain
- Periumbilical, T10–T11 via lesser splanchnic nerve
- Meckel's diverticulum
- Vitelline duct remnant on the antimesenteric border ~60 cm from the valve, with its own vitelline artery from the SMA
When it goes wrong
Acute SMA occlusion — embolus from AF, recent MI or valve disease
Sudden severe periumbilical pain out of proportion to a soft abdomen, forceful bowel emptying, then peritonitis and lactic acidosis after 6–12 h; CT angiography, embolectomy or resection
Small bowel obstruction that strangulates
Colicky periumbilical pain turns constant with peritonism, fever and rising lactate — ischaemia that mandates immediate surgery
Practise this structure
1 question in the bank tagged Small Bowel.