Arterial blood supply

The arterial blood supply to the duodenum is provided by branches of the celiac trunk and the superior mesenteric artery. The duodenum is derived from both - the foregut (first and second parts) and midgut (third and fourth parts).

Therefore, the superior and descending parts of the duodenum until the major duodenal papilla are supplied by branches of the celiac trunk. In contrast, the duodenum distal to the major duodenal papilla, jejunum and ileum receive arterial blood from branches of the superior mesenteric artery. Overall, the blood supply of the duodenum is shared with the pancreas.

The main arterial supply to the duodenum is ensured by two superior (anterior and posterior) and two inferior (anterior and posterior) pancreaticoduodenal arteries:

Superior anterior and posterior pancreaticoduodenal arteries - arise from the gastroduodenal artery (it is a branch of the common hepatic artery that arises from the celiac trunk); they supply the superior and descending parts till the major duodenal papilla;
Inferior anterior and posterior pancreaticoduodenal arteries - branches of the superior mesenteric artery; they supply the remaining descending part, horizontal and ascending portions of the duodenum.

Venous drainage

The venous drainage of the duodenum is provided by veins that accompany the arteries and share their names. Overall, the venous drainage of the small intestine is provided by the portal venous system.

The venous drainage of the duodenum occurs via small duodenal veins that carry venous blood further to the superior and inferior pancreaticoduodenal veins. The pancreaticoduodenal veins follow the corresponding arteries and either directly or indirectly drain into the hepatic portal vein.

Pancreaticoduodenal veins

Each person has four pancreaticoduodenal veins:

Anterior superior pancreaticoduodenal vein
Posterior superior pancreaticoduodenal vein
Anterior inferior pancreaticoduodenal vein
Posterior inferior pancreaticoduodenal vein

The posterior superior pancreaticoduodenal vein drains into the hepatic portal vein, while the anterior superior pancreaticoduodenal vein flows into the gastrocolic trunk or the right gastro-omental vein.

The posterior and anterior inferior pancreaticoduodenal veins drain into the superior mesenteric vein or its first jejunal tributary.

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Blood supply of duodenum

Arterial blood supply