Answer to Good Cop, Bad Cop

Correct answer is A, the celiac trunk. The greater omentum receives its complete blood supply from the right and left gastroepiploic arteries. The right gastroepiploic artery is one of the two terminal branches of the gastroduodenal artery, itself a terminal branch of the common hepatic artery, one of the three main branches from the celiac trunk. The left gastroepiploic artery is generally smaller than the right gastroepiploic artery and it branches from the splenic artery near the tail of the pancreas. The splenic is one of the three main branches from the celiac trunk. The remaining arteries supply the midgut and hindgut organ derivatives, they do not provide any arterial blood to the greater omentum. Note that omental infarction is a rare cause of acute abdomen resulting from vascular compromise of the greater omentum. This condition has a non-specific clinical presentation and is usually managed conservatively. Also, this is a completely hypothetical question.  The tying of the celiac trunk would be considered a criminal action, given that the blood supply to all foregut organs would be compromised. The only situation in which this procedure takes place is in the harvesting of the viscera for transplantation.

1.= Celiac trunk

2.= Superior mesenteric a.

3.= Middle colic a.

4.= Right colic a.

5.= Inferior mesenteric a.

Answer to this question is based on material presented in lectures 9 of the Abdomen Lecture Series.