Total proctocolecotmy and end ileostomy is indicted in patients with significant co-morbidity, obesity, marginal or poor sphincter strength, stage II-IV upper or middle rectal
cancer, stage I-IV low rectal cancer and failed IPAA.
Rectosigmoid: perirectal, left colic, sigmoid mesenteric, sigmoidal, inferior mesenteric, superior rectal, middle rectal
Rectum: perirectal, sigmoid mesenteric, inferior mesenteric, lateral sacral, presacral, internal iliac, sacral promontory, superior rectal, middle rectal, inferior rectal
The anterior trunk gives superior vesical artery, inferior vesical artery, middle rectal artery, vaginal artery, obturator artery, uterine artery, internal pudendal artery and inferior gluteal artery.
Occasionally, it contributes to the middle rectal arterial supply and, in male, supplies vessels to the seminal vesicles and prostate (Standring, 2005).
A retrospective review of 22 patients who had superselective transcatheter microcoil embolization (STME) for a lower GI hemorrhage showed that 11 underwent embolizations in branches of the superior mesenteric artery, 9 had embolizations in branches of the inferior mesenteric artery, and 2 received catheterization through the internal iliac artery with embolization of the middle rectal