Branching Pattern Of Celiac Trunk Research Articles

Variations in the Branching Pattern of Coeliac Trunk: A Cadaveric Case Series

During routine cadaveric dissection for students, the authors found variations in three cadavers. A male cadaver of approximately 70 years of age showed a unique branch communicating the coeliac trunk with the Superior Mesenteric Artery (SMA). The right and left hepatic arteries gave smaller branches before entering into liver. In another male cadaver of approximately 60 years of age, the left hepatic artery was arising from the left gastric artery. The common hepatic artery gave rise to right gastric artery and gastroduodenal artery, after which it continued as right hepatic artery proper. This gave rise to cystic artery. The present series also observed quadrifurcation of coeliac trunk in a male cadaver of 70 years of age. It gave off four branches namely, splenic artery, left gastric artery, right hepatic artery and left hepatic artery. The gastroduodenal artery was arising from the left hepatic artery. The variations in the branching pattern of coeliac trunk is important for the surgeons during gastric surgeries, liver transplantation, pancreatic and gall bladder surgeries. Radiologists should be aware of such variations during reporting of Computed Tomography (CT) angiograms.

Unraveling Variations in Celiac Trunk and Hepatic Artery by CT Angiography to Aid in Surgeries of Upper Abdominal Region.

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.

English

BACKGROUND Celiac trunk (CT) is the first major abdominal branch of the aorta. Anatomic variations and accessory vessels have been reported with variable percentages. We report here a particularly rare variant involving absence of the celiac trunk in association with trifurcation of the common hepatic artery (CHA). The purpose of this study was to report the pattern of the celiac trunk and its anatomic variations in a sample of Mysore population. METHODS Celiac trunk dissection was performed in 10 fresh cadavers and 50 cases of contrast enhanced computed tomography (CECT) images of Mysore based subjects at JSS Medical College and Hospital aged 18 years and above were included. Celiac trunk variations, length, diameter, accessory vessels, and vertebral level of origin were described. RESULTS The branching pattern of coeliac trunk was observed in 60 cases (37 males, 23 females) by dissection and CECT scan method. Type I was found in 48 cases (80 %), Type I form 2a was found in 2 cases (3.3 %). Type II form 1 in 6 cases (10 %). Type III was observed in 1 case and in another case left hepatic artery (LHA) arising from coeliac trunk, Type VII was found in 2 cases (3.3 %). The length and diameter of coeliac trunk were analysed using descriptive statistics and mean ± SD for length was 1.8 ± 0.4 and diameter 0.5 ± 0.2 respectively. CONCLUSIONS Awareness of CT variations is important in surgical resection, transplantation, and interventional radiology procedure. KEY WORDS Celiac Trunk, Variations, Morphometry, Contrast Enhanced Computed Tomography Scan Method

Cadaveric study of branching pattern of celiac trunk with rare variations

Cadaveric study of branching pattern of celiac trunk with rare variations

Variation in the branching pattern of celiac trunk: a case report

AbstractArterial supply for the derivatives of foregut in the abdomen is provided by the branches of the celiac trunk. Celiac trunk is the first ventral branch of abdominal aorta and usually branches into splenic, common hepatic and left gastric arteries. Variations in the branching pattern of celiac trunk are common but in most of the people, they remain asymptomatic and go unnoticed. A good knowledge of these anatomical variations is important for surgeons undertaking various surgeries in the abdominal region and will help to minimise the complications related to abdominal surgery. Clinicians and radiologists should also be aware of any variations in the vascular pattern of the celiac trunk before performing angiographic examinations. In the current case, the celiac trunk divided into two branches; left gastric artery and hepato-splenic trunk. The hepato-splenic trunk further divided into splenic and common hepatic arteries. The common hepatic artery trifitrcated into proper hepatic, gastroduodenal and accessory hepatic arteries. Hepatic artery proper divided into right and left hepatic arteries. The accessory hepatic artery was tortuous and was as large as the left hepatic artery. It gave origin to the right gastric artery and entered the liver through left end of porta hepatis.

A rare variant angioarchitecture of upper abdomen

Vascular anomalies are frequently encountered in abdomen. But they are usually asymptomatic and diagnosed accidently during angiography or surgery leading into severe complications. Thus knowledge of angioarchitecture in abdomen, whether normal or variant, is considered prerequisite for successful, uncomplicated surgeries and interventional radiology. This case report describes one of such varying branching pattern of celiac trunk and superior mesenteric artery. During routine abdominal dissection, gastroduodenal artery was seen arising from celiac trunk along with its usual three branches. Common hepatic artery continued as left hepatic artery after giving rise the right gastric artery and a tortuous replaced right hepatic artery arose from superior mesenteric artery. An unusually long cystic artery arose from left hepatic artery and gave rise to 2-3 small anastomotic branches towards hepatic flexor of colon, in addition to its normal gallbladder supply. Awareness of such variations would certainly be helpful in upper abdominal surgeries.

A Unique Branching Pattern of Celiac Trunk. Its Clinical and Embryological significance

The celiac trunk is the first ventral branch of the abdominal aorta and is the major blood supply to the supracolic abdominal compartment. Usually, three branches arise from the celiac trunk to supply this region, the splenic, the common hepatic and the left gastric arteries. During a routine dissection in the anatomy laboratory an extraordinary anatomical variation of the celiac trunk and its branches is found. The present case correspond of a celiac trunk, which gave off six branches. It gave off three classical branches, that is left gastric, splenic and common hepatic arteries. Beside these three branches, the right and left inferior phrenic arteries, and the superior posterior pancreaticoduodenal artery arose from the celiac axis. These anatomical variations were accompanied by a right gastric artery arising from the grastroduodenal artery instead of the common hepatic artery as describe in textbooks.During normal development, both dorsal aortas give rise to many ventral segmental (omphalomesenteric) arteries. The ventral segmental arteries regress shortly after fusion of dorsal aortas. The dorsal aorta gives off segmental branches to the digestive tube (ventral splanchnic arteries), the mesonepheric ridge (lateral splanchnic arteries), and intersegmental branches to the body wall (somatic arteries). Anatomical variations of the coeliac trunk are due to developmental changes in the ventral segmental arteries. These ventral segmental arteries supply the yolk sac, allantois and chorion. Three ventral segmental arteries remain as coeliac trunk, superior mesenteric artery and inferior mesenteric artery. Anatomical variations in the branching pattern of the celiac trunk are of considerable importance in liver transplants, laparoscopic surgery, invasive radiological interventions and penetrating injuries to the abdomen. Knowledge of variation found in the present case is very useful to kept in mind to avoid serious vascular complications.

Variation in the branching pattern of coeliac trunk-Case report

The Coeliac trunk is the first Ventral branch of abdominal aorta arising at the level of twelfth thoracic (T12) vertebra. The hepatic, splenic and left gastric arteries are considered as main classic branches of Coeliactrunk. We report a case of variation in the branching pattern of Coeliac trunk wherein the left inferior phrenic artery was seen arising from left gastric artery and there were two accessory hepatic arteries, one of them arising from left gastric artery and another one arising from common hepatic artery distal to the origin of hepatic artery. Cystic artery was seen arising from accessory hepatic artery. The right gastric artery is arising from gastro-duodenal artery. The gallbladder was distended with multiple stones, the wall of the gallbladder was thickened and there were adhesions connecting the gallbladder to liver bed and portahepatis. Knowledge of these vascular anomalies is important in handling patients undergoing diagnostic angiography for gastrointestinal bleeding, Coeliac axis compression syndrome or prior to an operative procedure or transcatheter therapy. Key WordsAccessory hepatic arteries,Coeliac trunk, gallbladder,Left gastric artery, Right gastric artery.