scholarly journals Extraordinary first jejunal arterial variation associated with annular pancreas undergoing pancreaticoduodenectomy for pancreatic cancer: a case report

2021 ◽  
Author(s):  
Yasuhito Iwao ◽  
Daisuke Ban ◽  
Satoru Muro ◽  
Atsushi Kudo ◽  
Shinji Tanaka ◽  
...  
Keyword(s):  
Case Report ◽  
Hepatic Artery ◽  
Anatomical Variations ◽  
Left Gastric Artery ◽  
Annular Pancreas ◽  
Ductal Adenocarcinoma ◽  
Arterial Variation ◽  
Surgical Safety ◽  
Pancreas Head ◽  
Arterial Variations

Abstract Purpose Annular pancreas encountered in adults and jejunal arterial variations are rare. Anatomical variations can cause conflicts between oncology and surgical safety. Methods Case report of a 68-year-old man suffering from vomiting because of an annular pancreas and a ductal adenocarcinoma of the pancreas head invading the second portion of the duodenum. Results Contrast-enhanced computed tomography showed multiple arterial variations describing the absence of the coeliac trunk such that the left gastric artery (LGA), splenic artery and superior mesenteric artery (SMA) were arising separately from the aorta. The accessory left hepatic artery arose from the LGA; and both the common hepatic artery and combined trunk of the replaced right hepatic artery with the higher replaced first jejunal artery separately arose close to the root of the SMA. The patient underwent curative pancreaticoduodenectomy which achieved 3 years of recurrence-free survival. Conclusion This was an extraordinary case of annular pancreas with first jejunal arterial variation detailing an embryological interpretation as well as considerations for balancing short- and long-term outcomes.

scholarly journals Variations of the Branches of the Coeliac Trunk: a Case Report

2012 ◽  
Vol 2 (3) ◽  
pp. 148-150
Author(s):  
Ashalatha Kasukurthy
Keyword(s):  
Case Report ◽  
Hepatic Artery ◽  
Anatomical Variations ◽  
Common Hepatic Artery ◽  
Medical Sciences ◽  
Inferior Phrenic Artery ◽  
Arterial Variations ◽  
Accurate Knowledge ◽  
Phrenic Artery ◽  
Coeliac Trunk

The hepatic, splenic and left gastric arteries are considered as the “main classic branches” of the coeliac trunk. We reported two cases of coeliac trunk. Left inferior phrenic artery arose directly from coeliac trunk and accessory hepatic artery arose from common hepatic artery. In our opinion; arterial variations should not be ignored during abdominal operative procedures. Complications in abdominal surgeries could be avoided with the accurate knowledge of the anatomical variations of coeliac trunk. DOI: http://dx.doi.org/10.3126/ajms.v2i3.4248 Asian Journal of Medical Sciences 2 (2011) 148-150

scholarly journals Arterial diameter of the celiac trunk and its branches: anatomical study

2009 ◽  
Vol 24 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Luís Augusto da Silveira ◽  
Fernando Braga Cassiano Silveira ◽  
Valéria Paula Sassoli Fazan
Keyword(s):  
Hepatic Artery ◽  
Celiac Trunk ◽  
Anatomical Study ◽  
Anatomical Variations ◽  
Left Gastric Artery ◽  
Gastric Artery ◽  
Arterial Diameter ◽  
Significant Difference ◽  
Diameter Reduction ◽  
Formalin Fixed

PURPOSE: Despite the fact that anatomical variations of the celiac trunk are well explored in the literature, information on these vessels diameters is scanty. The aims of the present study were to describe the arterial diameters of the celiac trunk and its main branches, and to investigate if these diameters are altered in those cases presenting anatomical variations of these vessels. METHODS: Twenty-one formalin fixed adult male cadavers were appropriately dissected for the celiac trunk identification and arterial diameter measurements. Arteries measured included the celiac trunk and its main branches (splenic artery, left gastric artery and common hepatic artery), as the proper hepatic artery, right gastric artery, the left and right hepatic arteries and the gastroduodenal artery. RESULTS: From the 21 cadavers, 6 presented anatomical variations of, at least, one of the above mentioned branches. The average arterial diameter comparisons between groups (normal and variable) clearly showed smaller diameters for variable vessels, but with no significant difference. CONCLUSION: Our data indicates the possibility of a diameter reduction of the celiac trunk main branches in the presence of anatomical variations. This should be taken into account on the selection for the liver transplantation donors.

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

2015 ◽  
Vol 32 (03) ◽  
pp. 200-202
Author(s):  
S. Nayak ◽  
A. Aithal ◽  
S. Shetty ◽  
N. Kumar ◽  
S. Ravindra ◽  
...  
Keyword(s):  
Hepatic Artery ◽  
Celiac Trunk ◽  
Anatomical Variations ◽  
Left Gastric Artery ◽  
Branching Pattern ◽  
Gastric Artery ◽  
Current Case ◽  
Hepatic Arteries ◽  
The People ◽  
The Right

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.

scholarly journals Absence of the celiac trunk and trifurcation of the common hepatic artery: a case report

2016 ◽  
Vol 15 (3) ◽  
pp. 259-262
Author(s):  
Satheesha Nayak Badagabettu ◽  
Ashwini Aithal Padur ◽  
Naveen Kumar ◽  
Deepthinath Reghunathan
Keyword(s):  
Case Report ◽  
Hepatic Artery ◽  
Rare Variant ◽  
Adult Male ◽  
Celiac Trunk ◽  
Anatomical Variations ◽  
Common Hepatic Artery ◽  
Review Of The Literature ◽  
Male Cadaver ◽  
The Common

Abstract Anatomical variations of the celiac trunk and its branches are particularly important from a surgical perspective due to their relationships with surrounding structures. We report here a particularly rare variant involving absence of the celiac trunk in association with trifurcation of the common hepatic artery. These variations were found in an adult male cadaver. We perform a review of the literature and discuss the clinical and embryological significance of these variations. Recognition of celiac trunk and hepatic artery variations is of utmost importance to surgeons and radiologists because multiple variations can lead to undue complications.

scholarly journals Anomalous Celiac Trunk Variation Encountered in Y-90 Radioembolization

2020 ◽  
Vol 3 ◽  
Author(s):  
Alexander Huang ◽  
Ramana Yedavalli
Keyword(s):  
Hepatic Artery ◽  
Celiac Trunk ◽  
Anatomical Variations ◽  
Left Gastric Artery ◽  
Arterial Supply ◽  
Right Hepatic Artery ◽  
Replaced Right Hepatic Artery ◽  
Ct Angiogram ◽  
The Right ◽  
Selection Of

Background:  Yttrium-90 microsphere embolization is a selective internal radiation therapy (SIRT) used in the treatment of hepatocellular carcinoma and liver metastases. Current literature recommends lobar, or more selective, infusion of SIRT to allow for precise radiation administration and to mitigate risk of non-target embolization. Lobar infusion requires knowledge of anatomical variations of hepatic arterial supply. The trifurcation of the celiac trunk into the left gastric artery, splenic artery, and common hepatic artery is the most common presentation representing 51% to 89% of patient anatomy. A replaced right hepatic artery (RHA) arising from the superior mesenteric artery (SMA) is one of the most common variants of hepatic arterial supply with a prevalence of 10.6% to 15%. Common variations such as these are well described and easily mapped using catheter angiography, but rarer variations are not as well described and more challenging to map.    Project Methods:  Mapping catheter angiogram of the celiac trunk and SMA was obtained. Additional aortogram and CT angiogram were obtained to further elucidate patient’s anatomy.    Results:  Initial mapping angiogram was only partially successful because the RHA could not be selected. Abdominal aortogram and CT angiogram of the abdomen and pelvis revealed a replaced RHA arising directly from the distal celiac trunk. Additionally, the patient had a replaced cystic artery arising from the left hepatic artery and an arc of Buhler connecting the proximal SMA to the proximal aspect of the right hepatic artery.    Conclusion:  Radiologists need to be aware of rare variations in hepatic arterial supply for the safe and effective treatment of hepatic neoplasms, whether primary or metastatic. Description of arterial variation and informed selection of arterial branches will remain a critical aspect of improving efficiency and reducing risks of hepatic embolization procedures. 

scholarly journals A CASE REPORT THAT A HEPATIC ARTERY AND LEFT GASTRIC ARTERY DIRECTRY ARISE FROM THE AORTA

1982 ◽  
Vol 43 (10) ◽  
pp. 1127-1130
Author(s):  
Toshiaki ARAI ◽  
Tadahiro TAKADA ◽  
Yasuhiko HUKUSHIMA ◽  
Haruomi MUTO ◽  
Yuko KINOSHITA ◽  
...  
Keyword(s):  
Case Report ◽  
Hepatic Artery ◽  
Left Gastric Artery ◽  
Gastric Artery
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