Central superior mesenteric nodes

At a glance

English

Central superior mesenteric nodes

Latin (TA2)

Nodi mesenterici superiores centrales

System

Lymphatic

Region

Trunk

Side

Single, on the midline

About the central superior mesenteric nodes

The superior mesenteric nodes are a large group, often more than a hundred nodes, in the mesentery of the small intestine and along the branches of the superior mesenteric artery. They are usually described in three tiers: the juxta-intestinal nodes close to the wall of the bowel, the intermediate nodes along the arterial arcades, and the central nodes. The central group lies around the main stem of the superior mesenteric artery, near its origin from the aorta behind the neck of the pancreas, and in the root of the mesentery.

Here the superior mesenteric artery and vein run together, crossing in front of the third part of the duodenum and the uncinate process of the pancreas. The coeliac nodes lie just above, around the coeliac trunk, and the lumbar nodes around the aorta behind.

The central nodes are the final collecting station for lymph from the jejunum and ileum, the caecum and appendix, the ascending colon and much of the transverse colon. They receive it after it has passed through the nodes nearer the bowel and along the ileocolic, right colic and middle colic arteries. Lymph leaving them, rich in absorbed fat after a meal, forms the intestinal trunk, which empties into the cisterna chyli at the start of the thoracic duct.

In surgery for cancer of the right or transverse colon, the extent of removal along the vessels towards these central nodes affects how completely the disease is cleared. They are also a frequent site of lymphoma in the abdomen, and may enlarge in inflammatory bowel disease and in mesenteric adenitis.

Course and drainage

Begins at

Afferent vessels from the intermediate and juxta-intestinal superior mesenteric nodes and from the ileocolic, right colic and middle colic nodes, carrying lymph from the jejunum, ileum, caecum, appendix, ascending and much of the transverse colon.

Drains into

Efferent vessels form the intestinal trunk, which empties into the cisterna chyli, partly with the coeliac nodes.

Drains

The main collecting station for lymph and absorbed fat from the small intestine and right colon. Important in colon cancer surgery, and a common site of abdominal lymphoma.