middle rectal artery

The middle rectal artery, also known as the middle hemorrhoidal artery, is a branch from the anterior division of the internal iliac artery supplying the rectum.


Gross anatomy


The middle rectal artery originates from the anterior division of the internal iliac artery.


It passes inferiorly towards the lower rectum, which it then supplies by splitting into several smaller branches prior to entering the rectum. It reaches the lower rectum laterally, along the lateral rectal ligament.


If a prostatic branch is present, it may also supply the seminal vesicle and prostate but more commonly, these branches arise from the inferior vesical artery.


The middle rectal artery supplies the inferior rectum, and anastomoses with the superior and inferior rectal arteries here.

Variant anatomy

The middle rectal artery may arise from a common origin with the inferior vesical artery. It may also arise from the internal pudendal artery, inferior gluteal artery or directly off the internal iliac artery. It may occasionally be absent in both sexes. It is more often absent in women than men. In some cases it may be replaced by an uterine artery. In males, the prostatic artery may arise from the middle rectal artery instead of from the inferior vesical artery.

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