Abstract
Understanding of variations in the course and source of abdominal arteries is crucial for any surgical intervention in the peritoneal space. Intricate surgeries of the upper abdominal region, such as hepato-biliary, pancreatic, gastric and splenic surgeries, require precise knowledge of regular anatomy and different variations related to celiac trunk and hepatic artery. In addition, information about the origin of inferior phrenic artery is important in conditions such as hepatocellular carcinoma and gastroesophageal bleeding management. The present study gives an account of anatomical variations in origin and branching pattern of celiac trunk and hepatic artery by the use of CT (computed tomographic) angiography. The study was performed on 110 (66 females and 44 males) patients in a north Indian population. Results unraveled the most common celiac trunk variation as hepatosplenic trunk with left gastric artery, which was observed in 60% of cases, more common in females than in males. Gastrosplenic and hepato-gastric trunk could be seen in 4.55% and 1.82% cases respectively. Gastrosplenic trunk was more commonly found in females, whereas hepato-gastric trunk was more common in males. A gastrosplenic trunk, along with the hepato-mesenteric trunk, was observed in 1.82% cases and was more common in males. A celiacomesenteric trunk, in which the celiac trunk and superior mesenteric artery originated as a common trunk from the aorta, was seen only in 0.91% of cases, and exhibited an origin of right and left inferior phrenic artery from the left gastric artery. The most common variation of hepatic artery, in which the right hepatic artery was replaced and originated from the superior mesenteric artery, was observed in 3.64%, cases with a more common occurrence in males. In 1.82% cases, the left hepatic artery was replaced and originated from the left gastric artery, which was observed only in females. Common hepatic artery originated from the superior mesenteric artery, as observed in 1.82% cases, with slightly higher occurrence in males. These findings not only add to the existing knowledge apart from giving an overview of variations in north Indian population, but also give an account of their correlation with gender. The present study will prove to be important for various surgeries of the upper abdominal region.
Highlights
IntroductionComprehensive knowledge of regular anatomy and variations in blood vessels is important for complicated surgeries, and aids in the procedures
Patients were between 18–60 age group belonging to a north Indian population; the study was a side stream of evidence-based patient management, where angiography was performed for clinical symptoms ranging from non-specific abdominal pain to suspected vascular abnormality, Diagnostics 2021, 11, 2262 such as aortic aneurism
A detailed knowledge of the anatomy and variations of the celiac trunk and the hepatic artery is essential to perform complex surgical procedures related to the upper abdomen [56]
Summary
Comprehensive knowledge of regular anatomy and variations in blood vessels is important for complicated surgeries, and aids in the procedures. Variations in celiac trunk and hepatic artery are of utmost importance during hepato-biliary, pancreatic, gastric and splenic surgeries. The celiac trunk originates at the T12 thoracic vertebrae level as the first ventral branch of the abdominal aorta and divides into the left gastric, common hepatic and splenic artery. The reported variations in origin and branching pattern of celiac trunk have been found to be valuable for surgical and radiological procedures in the epigastric region [17,18,19,20,21,22,23,24,25,26]. Numerous classification systems have been given for the variations in the origin and branching pattern of the celiac trunk [12,27,28,29], out of which Adachi’s classification is well known, and many arterial patterns of celiac trunk have been reported based on it [29,30,31,32,33,34]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
