ARTICLE TYPE : REVIEW ARTICLE
Published on : 29 Jan 2026, Volume - 2
Journal Title : WebLog Journal of Anatomy | WebLog J Anat
Source URL: 
https://weblogoa.com/articles/wjat.2026.a2901
Permanent Identifier (DOI) : 
https://doi.org/10.5281/zenodo.18464008
Applied Clinical Anatomy of Gut Vascular Supply: A Narrative Review of Segmental Perfusion, Watershed Vulnerability, and Surgical Implications
2Department of Pediatric Surgery, PGICHR and KTCGUH, Rajkot 360001, Gujarat, India
3Care Gastroenterology Medical Group, California, USA
4Department of Pediatric Surgery, Nottingham University Hospitals, Nottingham, UK
5J. Watumull Global Hospital & Research Centre, Delwara Road, Mount Abu, Rajasthan 307501, India Affiliated to Medical Faculty of God Fatherly Spiritual University, Mount Abu, Rajasthan, India
Abstract
Objectives: To synthesise the applied clinical anatomy of gastrointestinal vascular supply with emphasis on watershed zones, circumferential perfusion patterns, and mechanisms of vascular compromise. The review aims to provide surgeons and clinicians with a practical, anatomically grounded framework for understanding perfusion vulnerability, intraoperative decision-making, and the pathophysiology of ischemic injury.
Design: Narrative review integrating anatomical, surgical, radiological, and physiological literature with clinically oriented interpretation. Enhanced diagrams and comparative tables are used to support clarity and accessibility.
Data Sources: Searches were conducted in PubMed, Embase, Scopus, and Google Scholar for literature relating to gastrointestinal vascular anatomy, mesenteric perfusion, watershed zones, ischemic colitis, and surgical assessment of bowel viability. Additional sources included anatomical atlases, operative textbooks, and key clinical reviews.
Eligibility Criteria: Materials addressed included arterial and venous anatomy of the gut, watershed regions and collateral pathways, mechanisms of ischemia and perfusion failure, surgical relevance of vascular anatomy, clinical or intraoperative assessment of bowel viability
Results: The review highlights the segmental and collateral vascular architecture of the gut, with particular focus on: • The unique vascular features of the oesophagus, stomach, duodenum, jejunum, ileum, appendix, and colon • Critical watershed zones at Griffith’s point and Sudeck’s point, where perfusion is most vulnerable • The role of circumferential blood supply and the antimesenteric border in early ischemic change • The impact of bowel distention, volvulus, and venous congestion on perfusion compromise • Practical intraoperative markers of viability and perfusion adequacy A clinically oriented synthesis is presented to support surgical planning, risk assessment, and interpretation of ischemic patterns.
Conclusions: Understanding the applied vascular anatomy of the gut is essential for safe surgical practice and accurate interpretation of ischemic pathology. Watershed zones, collateral variability, and circumferential perfusion patterns shape the gut’s vulnerability to ischemia and influence operative strategy. This review consolidates key anatomical and clinical principles into a practical reference framework for surgeons, gastroenterologists, and trainees.
Keywords: Gastrointestinal Vascular Anatomy; Mesenteric Circulation; Watershed Zones; Griffith’s Point; Sudeck’s Point; Bowel Ischemia; Antimesenteric Border; Mesenteric Perfusion; Ischemic Colitis; Bowel Viability Assessment; Surgical Anatomy; Collateral Circulation; Intestinal Distention; Venous Congestion; Perfusion Imaging
Citation
Zaparackaite I, Govani ND, Singh H, Singh SJ, Mehta AR, Midha PK, et al. Applied Clinical Anatomy of Gut Vascular Supply: A Narrative Review of Segmental Perfusion, Watershed Vulnerability, and Surgical Implications. WebLog J Anat. wjat.2026.a2901. https://doi.org/10.5281/zenodo.18464008