A 68-year-old woman on frusemide develops sudden left-sided abdominal pain and bloody diarrhoea. Plain abdominal radiograph shows thumbprinting at the splenic flexure. Which vascular anatomy explains the preferential involvement of this site?
- A It receives dual supply from the middle colic and left colic arteries
- B It is the watershed between the superior and inferior mesenteric arteries ✓
- C It is supplied solely by the sigmoid branches of the inferior mesenteric artery
- D It is the watershed between the ileocolic and right colic arteries
Correct answer: B. It is the watershed between the superior and inferior mesenteric arteries
Explanation
The splenic flexure lies at Griffiths point, the watershed between the terminal branches of the superior mesenteric artery (middle colic) and the inferior mesenteric artery (left colic), making it vulnerable to hypoperfusion. Thumbprinting reflects submucosal haemorrhage and oedema. The other watershed, Sudeck point, sits between the superior rectal and last sigmoid artery near the rectosigmoid junction, not the flexure.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.