The abdominal arteries arise from the abdominal aorta and are comprised of three groups of arteries: unpaired visceral arteries, paired visceral arteries, and parietal arteries. The unpaired visceral arteries supply the gastrointestinal (GI) tract, spleen, pancreas, gallbladder, and liver and are made up of the celiac trunk, superior mesenteric artery (SMA), and inferior mesenteric artery (IMA). The paired visceral arteries supply the kidneys, adrenal glands, and gonads and are made up of the middle suprarenals, renals, and gonadal branches of the abdominal aorta. The parietal arteries supply the musculoskeletal structures of the abdominal wall and are made up of the inferior phrenic, lumbar, and median sacral branches of the abdominal aorta.

The celiac trunk is one of the major abdominal arteries and arises from the anterior aspect of the aorta at the T12 level of the aortic hiatus of the diaphragm. The celiac artery supplies oxygen-rich blood to the abdominal esophagus, stomach, liver, spleen, and superior portions of the duodenum and pancreas, which are collectively known as the embryonic foregut derivatives except the spleen. As a major branch of the abdominal aorta without extensive anastomosis with the other gut arteries, the celiac trunk is a vital artery that if ligated would result in severe foregut necrosis.[1]

The celiac artery gives rise to three major branches, including the left gastric, splenic, and common hepatic arteries. Collectively, these major branches of the celiac artery supply the stomach, spleen, liver, gallbladder, abdominal esophagus, pancreas, and duodenum. The left gastric artery gives rise to the esophageal branches and continues as the lesser curvature of the stomach to anastomose with the right gastric artery and supply the stomach. The splenic artery is contained within the splenorenal ligament and runs posterior to the stomach and along the superior pancreas.[2] Not only does the splenic artery supply the spleen, but it also gives rise to the left gastroepiploic, short gastric, and pancreatic arterial branches. The left gastroepiploic supplies the greater curvature of the stomach, the short gastrices supply the fundus of the stomach, and the pancreatic branches supply the body and tail of the pancreas. The common hepatic arteries are the only arterial supply to the liver and divide into the proper hepatic and gastroduodenal arteries. The proper hepatic arteries ascend through the lesser omentum and give rise to the right gastric, right and left hepatic, and cystic arteries. The right gastric supplies the pylorus and lesser curvature of the stomach, the right and left hepatic supply the corresponding liver lobes, and the cystic branch supplies the gallbladder. The gastroduodenal arteries descend posterior to the duodenum and give rise to the right gastroepiploic and superior pancreaticoduodenal arteries. The right gastroepiploic artery supplies the greater curvature of the stomach, and the superior pancreaticoduodenal artery supplies the head of the pancreas.  

The SMA arises inferior to the celiac trunk origin and supplies arterial blood to the midgut organs, which involves the major duodenal papilla to the proximal two-thirds of the transverse colon. The SMA branches anteriorly from the abdominal aorta at L1 and gives rise to the inferior pancreaticoduodenal artery, jejunal and ileal arteries, middle and right colic arteries, and ileocolic artery. The inferior pancreaticoduodenal artery supplies the inferior portion of the pancreas head, the uncinate process, and the duodenum. The jejunal and ileal arteries supply the jejunum and ileum through anastomotic arcades known as the vasa recta. The middle and right colic arteries supply the transverse and ascending colon, respectively. The ileocolic artery gives rise to branches supplying the ascending colon, appendix, cecum, and ileum.  

The IMA arises at L3 near the inferior border of the duodenum and supplies the hindgut organs, including the large intestine from the splenic flexure, descending colon, sigmoid colon, and the upper part of the rectum. The three major branches of the IMA are the left colic, sigmoid, and superior rectal arteries. The left colic artery supplies the distal third of the transverse colon and the descending colon. The sigmoid arteries supply the descending colon and the sigmoid colon. The superior rectal artery supplies the rectum and gives rise to branches that communicate with the middle and inferior rectal arteries.

The gut embryology starts as a midline endoderm-lined tube that is divided into foregut, midgut, and hindgut regions. The celiac trunk and its branches derive from foregut development, the SMA and its branches derive from midgut development, and the IMA and its branches derive from the hindgut development. The vitelline arteries initially supply the yolk sac and gradually fuse to form the dorsal mesentery arteries of the gut, which become the celiac and SMA. The umbilical arteries course to the placenta with the allantois and eventually give rise to the IMA.

Lymphatic drainage from the retroperitoneal abdominal viscera drains medially and courses back to the lumbar and visceral preaortic (celiac, superior mesenteric, and inferior mesenteric nodes) and lateral aortic lymph nodes. The lymph is collected into the cisterna chyli and brought back to the venous system by the thoracic duct.[3]

Retroperitoneal visceral structures are supplied by parasympathetic fibers from the vagus nerve and by pelvic splanchnic nerves S2-S4. The celiac trunk and midgut parasympathetic nerve supply include the vagus nerve, while the sympathetic nerve supply involves the thoracic splanchnic T5-T11 for celiac artery and T11-T12 for the SMA. The IMA parasympathetic nerve supply involves the pelvic splanchnic S2-S4, while the sympathetic nerve supply includes the lumbar splanchnic L1-L2. Pain sensation afferents from the abdominal viscera course through the spinal cord in a retrograde fashion through the thoracic and lumbar splanchnic sympathetic nerves T5-L2. Somatic nerves of the posterior abdominal wall are formed from the lumbar plexus L1-L4.