PURPOSE: 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.
(C) The ASCRS 2005