Clinical relevance of the arterial supply to the proximal rectum
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Abstract: Although the rectum is considered to be an organ rich in vascularity, the exact role of the middle rectal artery appears to be an area of much debate. Despite its principal supply from the superior rectal artery, there is a lack of information regarding the arterial supply to the fractionized proximal rectal regions. The approach to operative procedures in the case of recto-sigmoid carcinoma, intestinal embolization and haemorrhoidal disease are considered to be largely dependent on the intramural rectal anastomosis. Since the subsequent outcome of surgical intervention lies in the preservation of the respective rectal arteries, this study aimed to identify the proximal rectal arterial supply and the bilateral presence and/or variation of the middle rectal artery in ten fetal and ten adult cadaveric specimens (n=40). While the superior rectal artery presented as the principal arterial source to the proximal rectum, the respective regions of the proximal rectum were also found to be supplied by the median sacral and middle rectal arteries. The inconsistent morphological inconstant nature of the middle rectal artery confirmed that it does not represent the principal arterial source of the proximal rectum; however it was postulated that the middle rectal artery is regularly present in female individuals.