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Foregut, midgut and hindgut
The three embryologic divisions of the gut — which artery supplies each, what they contain, their parasympathetic supply and where their visceral pain is felt.
| Division | Artery (level) | Main branches | Supplies | Parasympathetic | Visceral pain |
|---|---|---|---|---|---|
| Foregut | Celiac trunk (T12) | Left gastric, splenic, common hepatic | Abdominal esophagus, stomach, duodenum proximal to the major papilla, liver, gallbladder and biliary tree, pancreas (with the SMA); the spleen develops in the foregut mesentery | Vagus nerve | Epigastrium |
| Midgut | Superior mesenteric artery (L1) | Inferior pancreaticoduodenal, jejunal and ileal, middle colic, right colic, ileocolic | Duodenum distal to the major papilla, jejunum, ileum, cecum, vermiform appendix, ascending colon and the proximal two-thirds of the transverse colon | Vagus nerve | Periumbilical |
| Hindgut | Inferior mesenteric artery (L3) | Left colic, sigmoid, superior rectal | Distal third of the transverse colon, descending and sigmoid colon, upper rectum | Pelvic splanchnic nerves (S2–S4) | Suprapubic |
Collaterals: the pancreaticoduodenal arcades join the celiac trunk and SMA; the marginal artery (of Drummond) joins the SMA and IMA.
Watershed zones of the colon: the splenic flexure and the rectosigmoid — the usual sites of ischemic colitis.
The foregut–midgut junction lies just distal to the major papilla.
Early appendicitis pain is periumbilical because midgut afferents enter the cord at about T10, the dermatome of the umbilicus.