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Vein skeleton of a Hydrangea leaf showing anastomoses of veins

An anastomosis (/əˌnæstəˈmsɪs/, pl.: anastomoses) is a connection or opening between two things (especially cavities or passages) that are normally diverging or branching, such as between blood vessels, leaf veins, or streams. Such a connection may be normal (such as the foramen ovale in a fetus' heart) or abnormal (such as the patent foramen ovale in an adult's heart); it may be acquired (such as an arteriovenous fistula) or innate (such as the arteriovenous shunt of a metarteriole); and it may be natural (such as the aforementioned examples) or artificial (such as a surgical anastomosis). The reestablishment of an anastomosis that had become blocked is called a reanastomosis. Anastomoses that are abnormal, whether congenital or acquired, are often called fistulas.

The term is used in medicine,[1] biology, mycology, geology, and geography.


Anastomosis: medical or Modern Latin, from Greek ἀναστόμωσις, anastomosis, "outlet, opening", Gr ana- "up, on, upon", stoma "mouth", "to furnish with a mouth".[2] Thus the -stom- syllable is cognate with that of stoma in botany or stoma in medicine.

Medical anatomy[edit]

A network of blood vessels

An anastomosis is the connection of two normally divergent structures.[3] It refers to connections between blood vessels or between other tubular structures such as loops of intestine.


In circulatory anastomoses, many arteries naturally anastomose with each other; for example, the inferior epigastric artery and superior epigastric artery, or the anterior and/or posterior communicating arteries in the Circle of Willis in the brain. The circulatory anastomosis is further divided into arterial and venous anastomosis. Arterial anastomosis includes actual arterial anastomosis (e.g., palmar arch, plantar arch) and potential arterial anastomosis (e.g. coronary arteries and cortical branch of cerebral arteries). Anastomoses also form alternative routes around capillary beds in areas that do not need a large blood supply, thus helping regulate systemic blood flow.[citation needed]


Surgical anastomosis occurs when segments of intestine, blood vessel, or any other structure are connected together surgically (anastomosed). Examples include arterial anastomosis in bypass surgery, intestinal anastomosis after a piece of intestine has been resected, Roux-en-Y anastomosis and ureteroureterostomy. Surgical anastomosis techniques include Linear Stapled Anastomosis,[4] Hand Sewn Anastomosis,[4] End-to-End Anastomosis (EEA).[5] Anastomosis can be performed by hand or with an anastomosis assist device.[6] Studies have been performed comparing various anastomosis approaches taking into account surgical "time and cost, postoperative anastomotic bleeding, leakage, and stricture".[7]


Pathological anastomosis results from trauma or disease and may involve veins, arteries, or intestines. These are usually referred to as fistulas. In the cases of veins or arteries, traumatic fistulas usually occur between artery and vein. Traumatic intestinal fistulas usually occur between two loops of intestine (entero-enteric fistula) or intestine and skin (enterocutaneous fistula). Portacaval anastomosis, by contrast, is an anastomosis between a vein of the portal circulation and a vein of the systemic circulation, which allows blood to bypass the liver in patients with portal hypertension, often resulting in hemorrhoids, esophageal varices, or caput medusae.[citation needed]



In evolution, anastomosis is a recombination of evolutionary lineage. Conventional accounts of evolutionary lineage present themselves as the branching out of species into novel forms. Under anastomosis, species might recombine after initial branching out, such as in the case of recent research that shows that ancestral populations along human and chimpanzee lineages may have interbred after an initial branching event.[8] The concept of anastomosis also applies to the theory of symbiogenesis, in which new species emerge from the formation of novel symbiotic relationships.[citation needed]


In mycology, anastomosis is the fusion between branches of the same or different hyphae.[9] Hence the bifurcating fungal hyphae can form true reticulating networks. By sharing materials in the form of dissolved ions, hormones, and nucleotides, the fungus maintains bidirectional communication with itself. The fungal network might begin from several origins; several spores (i.e. by means of conidial anastomosis tubes), several points of penetration, each a spreading circumference of absorption and assimilation. Once encountering the tip of another expanding, exploring self, the tips press against each other in pheromonal recognition or by an unknown recognition system, fusing to form a genetic singular clonal colony that can cover hectares called a genet or just microscopical areas.[10]

For fungi, anastomosis is also a component of reproduction. In some fungi, two different haploid mating types – if compatible – merge. Somatically, they form a morphologically similar mycelial wave front that continues to grow and explore. The significant difference is that each septated unit is binucleate, containing two unfused nuclei, i.e. one from each parent that eventually undergoes karyogamy and meiosis to complete the sexual cycle.[citation needed]

Also the term "anastomosing" is used for mushroom gills which interlink and separate to form a network.[11]

Anastomosing gills of Marasmius cf. cladophyllus


The growth of a strangler fig around a host tree, with tendrils fusing together to form a mesh, is called anastomosing.[12]


In geology, veins of quartz (or other) minerals can display anastomosis.[13]

Ductile shear zones frequently show anastomosing geometries of highly-strained rocks around lozenges of less-deformed material.[14]

Braided streams show anastomosing channels around channel bars of alluvium.[15]

Molten lava flows sometimes flow in anastomosed lava channels[16] or lava tubes.[17]


Anastomosing streams consist of multiple channels that divide and reconnect and are separated by semi-permanent banks formed of cohesive material, such that they are unlikely to migrate from one channel position to another. They can be confused with braided rivers based on their planforms alone, but braided rivers are much shallower and more dynamic than anastomosing rivers. Some definitions require that an anastomosing river be made up of interconnected channels that enclose floodbasins,[18] again in contrast with braided rivers. Rivers with anastomosed reaches include the Magdalena River in Colombia,[19] the upper Columbia River in British Columbia, Canada,[20] the Drumheller Channels of the Channeled Scablands of the state of Washington, US, and the upper Narew River in Poland.[21] The term anabranch has been used for segments of anastomosing rivers.

In cave systems anastomosis is the splitting of cave passages that later reconnect.[22]


  1. ^ "Online ICD9/ICD9CM codes". Retrieved 2022-01-24.
  2. ^ Online Etymology Dictionary Douglas Harper
  3. ^ Gylys, Barbara A.; Mary Ellen Wedding (2005), Medical Terminology Systems, F.A. Davis Company
  4. ^ a b "Laparoscopic Anastomotic Techniques - A SAGES Wiki Article". SAGES. Retrieved 2018-06-28.
  5. ^ Akelina, Yelena (2014-03-31). "Microsurgical Technique for 1mm Vessel End to End Anastomosis". Journal of Medical Insight. 2014 (3). doi:10.24296/jomi/2. ISSN 2373-6003.
  6. ^ Kikuchi, Keita; Tambara, Keiichi; Yamamoto, Taira; Yamasaki, Motoshige; Hirose, Hitoshi; Amano, Atsushi (2010). "The Use of Enclose®II Anastomosis Assist Device for the Proximal Coronary Branch Anastomosis to Vascular Graft". Annals of Vascular Diseases. 3 (1): 84–86. doi:10.3400/avd.hdi08023. ISSN 1881-641X. PMC 3595814. PMID 23555395.
  7. ^ Yao, Libin; Li, Chao; Zhu, Xiaocheng; Shao, Yong; Meng, Song; Shi, Linsen; Wang, Hui (2016-11-26). "An Effective New Intestinal Anastomosis Method". Medical Science Monitor. 22: 4570–4576. doi:10.12659/MSM.902000. ISSN 1234-1010. PMC 5138069. PMID 27888280.
  8. ^ Patterson, Nick; et al. (May 2006). "Genetic evidence for complex speciation of humans and chimpanzees". Nature. 441 (7097): 1103–1108. Bibcode:2006Natur.441.1103P. doi:10.1038/nature04789. PMID 16710306. S2CID 2325560.
  9. ^ Kendrick, Bryce (2001), The Fifth Kingdom, Mycologue Publications
  10. ^ Glass L.; Rasmussen C.; Roca M.G.; Read N. (2004). "Hyphal homing, fusion and mycelial interconnectedness". Trends in Microbiology. 12 (3): 135–141. doi:10.1016/j.tim.2004.01.007. PMID 15001190.
  11. ^ Marcel Bon (1987). The Mushrooms and Toadstools of Britain and North-Western Europe. Hodder & Stoughton. p. 14. ISBN 978-0-340-39935-4.
  12. ^ Kricher, John C. (2017). The New Neotropical Companion (Revised ed.). Princeton, NJ: Princeton University Press. p. 52. ISBN 978-1400885589. OCLC 964359395.
  13. ^ C.E. Dorado J.C. Molano (2018). "Microthermometry and Raman spectroscopy of fluid inclusions from El Vapor gold mineralizations, Colombia". Earth Sciences Research Journal. 22 (3): 151–158. doi:10.15446/esrj.v22n3.63442.
  14. ^ Burg, J.-P.; Arbaret, L.; Chaudhry, N. M.; Dawood, H.; Hussain, S.; Zeilinger, G. (January 2005). "Shear strain localization from the upper mantle to the middle crust of the Kohistan Arc (Pakistan)". Geological Society, London, Special Publications. 245 (1): 25–38. Bibcode:2005GSLSP.245...25B. doi:10.1144/GSL.SP.2005.245.01.02. ISSN 0305-8719. S2CID 129641276.
  15. ^ Whitcomb, Lawrence (1947). "Anastomosing Vs. Braided Streams". Proceedings of the Pennsylvania Academy of Science. 21: 64–68. ISSN 0096-9222. JSTOR 44112178.
  16. ^ Dietterich, H.R.; Cashman, K.V. The creation and influence of bifurcations and confluences in Hawaiian lava flows on conditions of flow emplacement. American Geophysical Union, Fall Meeting 2011. Bibcode:2011AGUFM.V41A2484D. V41A-2484. Retrieved 17 October 2023.
  17. ^ Peterson, D.W.; Holcomb, R.T.; Tilling, R.I.; Christiansen, R.L. (1994). "Development of lava tubes in the light of observations at Mauna Ulu, Kilauea Volcano, Hawaii". Bulletin of Volcanology. 56 (5): 343–360. Bibcode:1994BVol...56..343P. doi:10.1007/BF00326461. S2CID 129741130.
  18. ^ Makaske, Bart (2001). "Anastomosing rivers: a review of their classification, origin and sedimentary products" (PDF). Earth-Science Reviews. 53 (3–4): 149–196. Bibcode:2001ESRv...53..149M. doi:10.1016/s0012-8252(00)00038-6. Archived from the original (PDF) on 2016-10-11. Retrieved 2016-08-21.
  19. ^ Smith, D (1986). "Anastomosing river deposits, sedimentation rates and basin subsidence, Magdalena River, northwestern Colombia, South America". Sedimentary Geology. 46 (3–4): 177–196. Bibcode:1986SedG...46..177S. doi:10.1016/0037-0738(86)90058-8.
  20. ^ Abbado, D., Slingerland, R.L., and Smith, N.D., 2005, The origin of anastomosis in the upper Columbia River, British Columbia, Canada: In Blum, M.D., Marriott, S., and Leclair. S. (eds.), Fluvial Sedimentology VII, Internat. Assoc. Sedim. Special Publ. 35.
  21. ^ Gradzinski, R (2003). "Vegetation-controlled modern anastomosing system of the upper Narew River (NE Poland) and its sediments". Sedimentary Geology. 157 (3–4): 253–276. Bibcode:2003SedG..157..253G. doi:10.1016/S0037-0738(02)00236-1.
  22. ^ "Glossary of Karst and Cave Terms: anastomosis". Retrieved 8 July 2022.