Abstract
Objective To describe the main anatomical variations of the celiac trunk and the hepatic artery at their origins.Materials and Methods This was a prospective analysis of 100 consecutive computed tomography angiography studies of the abdomen performed during a one-year period. The findings were stratified according to classification systems devised by Sureka et al. and Michels.Results The celiac trunk was "normal" (i.e., the hepatogastrosplenic trunk and superior mesenteric artery originating separately from the abdominal aorta) in 43 patients. In our sample, we identified four types of variations of the celiac trunk. Regarding the hepatic artery, a normal anatomical pattern (i.e., the proper hepatic artery being a continuation of the common hepatic artery and bifurcating into the right and left hepatic arteries) was seen in 82 patients. We observed six types of variations of the hepatic artery.Conclusion We found rates of variations of the hepatic artery that are different from those reported in the literature. Our findings underscore the need for proper knowledge and awareness of these anatomical variations, which can facilitate their recognition and inform decisions regarding the planning of surgical procedures, in order to avoid iatrogenic intraoperative injuries, which could lead to complications.
Highlights
The trifurcation of the celiac trunk was first described by Haller in 1756
In 1955, Michels developed a system for classifying the anatomical pattern of the celiac trunk, Study conducted in the Department of Anatomy and Radiology, School of Medicine, Universidade Estadual do Ceará (UECE), and at the Hospital Geral de Fortaleza (HGF), Fortaleza, CE, Brazil
We identified five patterns of anatomical variations: a hepatosplenic trunk with the left gastric artery emerging 0.4–2.5 cm above the bifurcation of the celiac trunk and the superior mesenteric artery emerging from the abdominal aorta, in 47% of the cases; a gastrosplenic trunk with the common hepatic artery and superior mesenteric artery originating from the abdominal aorta, in 2%; a gastrosplenic trunk with the hepatic artery emerging from the superior mesenteric artery, in 3%; a hepatosplenic mesenteric trunk with the left gastric
Summary
The trifurcation of the celiac trunk was first described by Haller in 1756. In 1955, Michels developed a system for classifying the anatomical pattern of the celiac trunk, Study conducted in the Department of Anatomy and Radiology, School of Medicine, Universidade Estadual do Ceará (UECE), and at the Hospital Geral de Fortaleza (HGF), Fortaleza, CE, Brazil. 1. PhD, Adjunct Professor of Clinical Surgery, School of Medicine, Universidade Estadual do Ceará (UECE), Head of the Liver Transplant Program at the Hospital Geral de Fortaleza (HGF), Fortaleza, CE, Brazil. 2. Medical Student at the Universidade Estadual do Ceará (UECE), Fortaleza, CE, Brazil. 3. PhD, Substitute Professor of Anatomy, School of Medicine, Universidade Estadual do Ceará (UECE), Fortaleza, CE, Brazil. In 1966, an international classification system for anatomical variations of the hepatic artery was proposed[1,2,3,4,5]
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