The marginal artery of Drummond revisited: A systematic review

Background: The marginal artery of Drummond (MA) is an anatomically variable blood vessel that forms a major anastomotic network between the superior and inferior mesenteric arteries. It vascularizes the transverse and descending colons and is a major contributor to the collateral circulation of left-colic structures. Purpose: To conduct a systematic review of the MA and highlight the current understanding of its anatomy and role in physiological and pathological vascularization. Methods: The major online databases (Pubmed, Google Scholar, Embase, and Web of Science) were systematically assessed to reveal all available literature pertaining to the MA. Articles judged relevant by the authors were used for the final review. Results: The MA is a key player in the collateral circulation of left-colic structures in the setting of pathological processes affecting their normal vascularization. It helps to maintain perfusion in the event of obstructions and atherosclerosis, and in the cases of obliteration or congenital absence of the mesenteric vessels, it sustains adequate vascularization of the left-colon. The MA has come into increasing prominence as surgeons have become more aware of both iatrogenic injuries to it and its value in mitigating the effects of reduced patency of the mesenteric vessels. Conclusions: The MA continues to become more important to surgeons as both an obstacle and an opportunity in abdominal procedures. Further exploration of its anatomical variability, for example through embryological and dissection studies, will further improve treatment outcomes during abdominal surgery