The artery of Moskowitz and intermesenteric connections: A comprehensive review of the collaterals between superior and inferior mesenteric arteries

Introduction: Intermesenteric arterial connections within the mesocolon between the transverse colon and the descending colon show various variations. These vessels are formed between the branches of the superior and inferior mesenteric arteries and are called the Moskowitz artery, arch of Riolan and Drummond artery. In this study, we aimed to show the incidence of the Moskowitz artery and intermesenteric anastomoses in cadavers. Methods: A total of 10 cadavers (4 male, 6 female) were included in the study. Taking aortic bifurcation as the starting point, the inferior mesenteric artery and its branch, the left colic artery, were dissected. Within the mesocolon transversum, the middle colic artery dissection and the presence of intermesenteric anastomoses were demonstrated. Results: In the dissections, Moskowitz artery was detected in only 3 cadavers and the arch of Riolan was observed in 7 cadavers. Drummond artery was seen in all cadavers. Moskowitz artery and arch of Riolan were seen simultaneously in 2 cadavers, while only Drummond artery was seen without Moskowitz artery and Riolan arch in 2 cadavers. Conclusion: The presence of intermesenteric anastomoses contributes significantly to the arterial supply of the transverse colon, splenic flexure and the descending colon. Although clinically these intermesenteric connections are seen in the population with a low incidence, these structures should be carefully dissected and protected during surgical interventions. Otherwise, if arterial structures are damaged, the arterial supply to these colon segments may be negatively affected and complications such as anastomotic leakage, ischemia and necrosis may occur in the postoperative period.