scholarly journals ANATOMICAL VARIATIONS OF THE SUPERIOR MESENTERIC ARTERY AND ITS CLINICAL AND SURGICAL IMPLICATIONS IN HUMANS

2020 ◽  
Vol 33 (2) ◽  
Author(s):  
Natasha Gabriela Oliveira da SILVA ◽  
Ana Beatriz Marques BARBOSA ◽  
Nathalie de Almeida SILVA ◽  
Diego Neves ARAÚJO ◽  
Thiago de Oliveira ASSIS
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Scientific Literature ◽  
Celiac Trunk ◽  
Anatomical Variations ◽  
Great Role ◽  
Place Of Origin ◽  
The Right ◽  
Clinical Conditions ◽  
Sample Method

ABSTRACT Introduction: Superior mesenteric artery (SMA) usually arises from the abdominal aorta, just below the celiac trunk and it supplies the midgut-derived embryonic structures. Anatomical variations in this vessel contribute to problems in the formation and/or absorption of this part of the intestine and its absence has been recognized as the cause of congenital duodenojejunal atresia. Objective: To analyze SMA anatomical variations in humans and the possible associated clinical and surgical implications. Methods: This is a systematic review of papers indexed in PubMed, SciELO, Springerlink, Science Direct, Lilacs, and Latindex databases. The search was performed by two independent reviewers between September and December 2018. Original studies involving SMA variations in humans were included. SMA presence/absence, level, place of origin and its terminal branches were considered. Results: At the end of the search, 18 studies were selected, characterized as for the sample, method to evaluate the anatomical structure and main results. The most common type of variation was when SMA originated from the right hepatic artery (6.13%). Two studies (11.11%) evidenced the inferior mesenteric artery originating from the SMA, whereas other two (11.11%) found the SMA sharing the same origin of the celiac trunk. Conclusion: SMA variations are not uncommon findings and their reports evidenced through the scientific literature demonstrate a great role for the development of important clinical conditions, making knowledge about this subject relevant to surgeons and professionals working in this area.

scholarly journals What comprises the plate-like structure between the pancreatic head and the celiac trunk and superior mesenteric artery? A proposal for the term “P–A ligament” based on anatomical findings

2021 ◽  
Author(s):  
Satoru Muro ◽  
Wachirawit Sirirat ◽  
Daisuke Ban ◽  
Yuichi Nagakawa ◽  
Keiichi Akita
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Pancreatic Head ◽  
Celiac Trunk ◽  
Dorsal Side ◽  
Uncinate Process ◽  
Anatomical Basis ◽  
The Right ◽  
Upper Abdomen ◽  
Macroscopic Examination

AbstractA plate-like structure is located posterior to the portal vein system, between the pancreatic head and roots and/or branches of two major arteries of the aorta: the celiac trunk and superior mesenteric artery. We aimed to clarify the distribution and components of this plate-like structure. Macroscopic examination of the upper abdomen and histological examination of the plate-like structure were performed on 26 cadavers. The plate-like structure is connected to major arteries (aorta, celiac trunk, superior mesenteric artery) and the pancreatic head; it contains abundant fibrous bundles comprising nerves, vessels, collagen fibers, and adipose tissue. Furthermore, it consists of three partly overlapping fibrous components: rich fibrous bundles (superior mesenteric artery plexus) fused to the uncinate process of the pancreas; fibrous bundles arising from the right celiac ganglion and celiac trunk that spread radially to the dorsal side of the pancreatic head and superior mesenteric artery plexus; and fibrous bundles, accompanied by the inferior pancreaticoduodenal artery, entering the pancreatic head. The plate-like structure is the pancreas–major arteries (aorta, celiac trunk, superior mesenteric artery) ligament (P–A ligament). The term “P–A ligament” may be clinically useful and can facilitate comprehensive understanding of the anatomy surrounding the pancreatic head and provide an anatomical basis for further pancreatic surgery studies.

scholarly journals A Unique Communicating Arterial Branch between the Celiac Trunk and the Superior Mesenteric Artery: A Case Report

2019 ◽  
Vol 7 (13) ◽  
pp. 2138-2141
Author(s):  
Adegbenro Omotuyi John Fakoya ◽  
Emilio Aguinaldo ◽  
Natalia M. Velasco-Nieves ◽  
Erica Barnes ◽  
Zachary T. Vandeveer ◽  
...  
Keyword(s):  
Case Report ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Anatomical Variation ◽  
Celiac Trunk ◽  
Anatomical Variations ◽  
Pancreaticoduodenal Artery ◽  
Case Presentation ◽  
Asymptomatic Case ◽  
Arterial Branch

BACKGROUND: Many anatomical variations have been associated with the Celiac Trunk, of which most are classified as being asymptomatic. CASE PRESENTATION: In this article, we describe yet another anatomical variation involving the Celiac Trunk, Superior Mesenteric artery and the Inferior Pancreaticoduodenal Artery during routine cadaveric dissection. We identified a fourth branch of the Celiac trunk (quadrification) that communicated with the Superior Mesenteric artery at the point of origin of the Inferior Pancreaticoduodenal artery which we concluded to be the Anterior Inferior Pancreaticoduodenal artery. CONCLUSION: This anastomosis could be essential in the case of occlusion between the Celiac Trunk and the Superior Mesenteric artery.

scholarly journals MDCT angiography of anatomical variations of the celiac trunk and superior mesenteric artery

2014 ◽  
Vol 66 (1) ◽  
pp. 233-240 ◽  
Author(s):  
Neda Ognjanovic ◽  
D. Jeremic ◽  
Ivana Zivanovic-Macuzic ◽  
Maja Sazdanovic ◽  
P. Sazdanovic ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Hepatic Artery ◽  
Mesenteric Artery ◽  
Celiac Trunk ◽  
Anatomical Variations ◽  
Common Hepatic Artery ◽  
Common Trunk ◽  
Mdct Angiography ◽  
The Common ◽  
Mdct Scanner

The aim of this study was to detect and describe the existence and incidence of anatomical variations of the celiac trunk and superior mesenteric artery. The study was conducted on 150 persons, who underwent abdominal Multi- Detector Computer Tomography (MDCT) angiography, from April 2010 until November 2012. CT images were obtained with a 64-row MDCT scanner in order to analyze the vascular anatomy and anatomical variations of the celiac trunk and superior mesenteric artery. In our study, we found that 78% of patients have a classic anatomy of the celiac trunk and superior mesenteric artery. The most frequent variation was the origin of the common hepatic artery from the superior mesenteric artery (10%). The next variation, according to frequency, was the origin of the left gastric artery direct from the abdominal aorta (4%). The arc of Buhler as an anastomosis between the celiac trunk and superior mesenteric artery, was detected in 3% of cases, as was the presence of a common trunk of the celiac trunk and superior mesenteric artery (in 3% of cases). Separate origin of the splenic artery and the common hepatic artery was present in 2% of patients. The MDCT scanner gives us an insight into normal anatomy and variations of the abdominal blood vessels, which is very important in the planning of surgical interventions, especially transplantation, as well as in the prevention of complications due to ischemia.

scholarly journals Anatomical variations of the celiac trunk and hepatic arterial system: an analysis using multidetector computed tomography angiography

2015 ◽  
Vol 48 (6) ◽  
pp. 358-362 ◽  
Author(s):  
Severino Aires Araujo Neto ◽  
Henrique Almeida Franca ◽  
Carlos Fernando de Mello Júnior ◽  
Eulâmpio José Silva Neto ◽  
Gustavo Ramalho Pessoa Negromonte ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Superior Mesenteric Artery ◽  
Multidetector Computed Tomography ◽  
Hepatic Artery ◽  
Mesenteric Artery ◽  
Celiac Trunk ◽  
Anatomical Variations ◽  
Arterial System ◽  
Cross Sectional ◽  
Computed Tomography Images

Abstract Objective: To analyze the prevalence of anatomical variations of celiac arterial trunk (CAT) branches and hepatic arterial system (HAS), as well as the CAT diameter, length and distance to the superior mesenteric artery. Materials and Methods: Retrospective, cross-sectional and predominantly descriptive study based on the analysis of multidetector computed tomography images of 60 patients. Results: The celiac trunk anatomy was normal in 90% of cases. Hepatosplenic trunk was found in 8.3% of patients, and hepatogastric trunk in 1.7%. Variation of the HAS was observed in 21.7% of cases, including anomalous location of the right hepatic artery in 8.3% of cases, and of the left hepatic artery, in 5%. Also, cases of joint relocation of right and left hepatic arteries, and trifurcation of the proper hepatic artery were observed, respectively, in 3 (5%) and 2 (3.3%) patients. Mean length and caliber of the CAT were 2.3 cm and 0.8 cm, respectively. Mean distance between CAT and superior mesenteric artery was 1.2 cm (standard deviation = 4.08). A significant correlation was observed between CAT diameter and length, and CAT diameter and distance to superior mesenteric artery. Conclusion: The pattern of CAT variations and diameter corroborate the majority of the literature data. However, this does not happen in relation to the HAS.

A Case Report of Hepato Spleno Mesenteric Trunk – A Rare Vascular Variation

2021 ◽  
Vol 10 (29) ◽  
pp. 2217-2220
Author(s):  
Jisha Sree Hasheem ◽  
Rohini Avantsa
Keyword(s):  
Case Report ◽  
Superior Mesenteric Artery ◽  
Abdominal Aorta ◽  
Mesenteric Artery ◽  
Splenic Artery ◽  
Surgical Techniques ◽  
Celiac Trunk ◽  
Anatomical Variations ◽  
Common Trunk ◽  
Vascular Variations

Major sources of the vascular supply of the gastrointestinal tract are the celiac trunk (CT) and superior mesenteric artery (SMA) which are the main proximal branches of the abdominal aorta. The CT gives rise to three branches normally as follows: left gastric artery (LGA), common hepatic artery (CHA) and splenic artery (SA). The branching pattern of the CT is considered as the most literature explained anatomical pattern.1 After the CT, the abdominal aorta gives the second named branch as superior mesenteric artery. Vascular variations of the celiac trunk and superior mesenteric artery are common and had been described earlier.2 These variations are caused due to the aberrant embryological development of splanchnic arteries. The incidence of hepato-spleno-mesenteric trunk has been reported by various authors as 0.68 %,3 0.7 %,4 0.3 %,5 0.4 %,6 or 1 %.7 The importance of knowledge of these variations lies in preplanning of invasive surgical techniques, organ transplantation, diagnosis, prevention, and management of some metastatic tumours and to overcome the catastrophic consequences like bowel ischemia due to common trunk.8 Hence a better understanding of these anatomical variations is considered vital for surgeons or radiologists for appropriate planning and conduction of surgical procedures or interventions.9 Most of the anatomical variations in abdominal aorta branches are asymptomatic and incidental findings while imaging for other aetiologies. But the identification of such vascular variations is of utmost importance in clinical practice. The Hepatospleno-mesenteric trunk [HSMT] is one of those variations and was less frequently reported. The authors describe a case report of the hepato-spleno-mesenteric trunk which was incidentally detected in the multi detector computed tomography study of the abdomen of a 54-year-old male patient who had been diagnosed to have chronic liver disease and hepatic encephalopathy. The origin of the HSMT [with a diameter of 11mm] occurs from the abdominal aorta at the level of the L2 vertebral body and is divided into the hepatosplenic trunk [diameter of 7 mm] and superior mesenteric artery [diameter of 7.5 mm] after coursing for a length of 28 mm. The hepatosplenic trunk ascends superiorly for a length of 20 mm and divided into two terminal branches: common hepatic (6 mm) and splenic artery (6 mm).

Anomalous arterial supply to the gallbladder from the superior mesenteric artery: angiography and computed tomography findings in two cases

2008 ◽  
Vol 49 (9) ◽  
pp. 987-990 ◽  
Author(s):  
Y. Katada ◽  
M. Kishino ◽  
K. Ishihara ◽  
T. Takeguchi ◽  
H. Shibuya
Keyword(s):  
Computed Tomography ◽  
Superior Mesenteric Artery ◽  
Hepatic Artery ◽  
Mesenteric Artery ◽  
Cystic Artery ◽  
Arterial Supply ◽  
Hepatic Arteries ◽  
Right Hepatic Artery ◽  
Pancreatic Artery ◽  
The Right

The arterial supply of the gallbladder usually arises from the right hepatic artery. Other origins include the left, proper, and common hepatic arteries. We report cases of the cystic artery arising from the superior mesenteric artery and arising from the dorsal pancreatic artery originating in turn from the superior mesenteric artery, as demonstrated by angiography and computed tomography.

Duplex Doppler sonography of celiac trunk and superior mesenteric artery: comparison with intra-arterial angiography

1993 ◽  
Vol 12 (6) ◽  
pp. 337-342 ◽  
Author(s):  
R Mallek ◽  
G H Mostbeck ◽  
R M Walter ◽  
A Stümpflen ◽  
T Helbich ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Doppler Sonography ◽  
Celiac Trunk ◽  
Duplex Doppler ◽  
Duplex Doppler Sonography

scholarly journals THE COMPARATIVE CHARACTERISTICS OF AGE, SEXUAL AND TYPOLOGICAL MORPHOMETRIC PARAMETERS OF UNPAIRED BRANCHES OF THE ABDOMINAL AORTA OF ADULTS ACCORDING COMPUTED TOMOGRAPHY

2019 ◽  
Vol 27 (2) ◽  
pp. 13-18
Author(s):  
I. V. Gaiyvoronsky ◽  
P. M. Bykov ◽  
M. G. Gaivoronskaya ◽  
G. I. Sinenchenko
Keyword(s):  
Superior Mesenteric Artery ◽  
Abdominal Aorta ◽  
Mesenteric Artery ◽  
Celiac Trunk ◽  
Morphometric Parameters ◽  
The Body ◽  
Body Type ◽  
Elderly Age ◽  
Main Trunk ◽  
Men And Women

The rapid development of transplantation, endovascular and minimally invasive surgery necessitates a detailed study of the structural features of the vessels of the abdominal cavity. The purpose of the study is the characteristics of the morphometric parameters of the abdominal aorta and its unpaired branches in men and women at different ages and depending on the body type. The analysis of 266 computer tomograms of the abdominal part of aorta and its unpaired branches was carried out in adult men women divided into three age groups (first and second periods of mature age and elderly age), as well as into three groups according to the Pinier index (asthenic, normosthenic and hypersthenic body types). It was established that individual morphometric parameters of the abdominal part of aorta and its unpaired branches in men and women significantly change with age. It is proved that the diameter of the aorta at various levels significantly increases with age from the first mature to the elderly age by an average of 5 mm. However, in men, the length of the abdominal aorta, celiac trunk and main trunk of the superior mesenteric artery does not change with age. In women, the length of the celiac trunk increases with age at 5.9 mm, the length of the main trunk of the superior mesenteric artery - at 17 mm. The angle of discharge of the celiac trunk in men changes unevenly with age - in the second period of mature age, there is a statistically significant decrease by an average to 12.3°, then in old age an increase to 15°. Moreover, in women, the values of this indicator vary more evenly. The angles of discharge of other vessels did not show a clear age dependence, since this parameter is largely due to the constitutional features. The aorto-mesenteric distance changes with age only in women. In elderly age, it is on average 4.4 mm larger than in the first period of mature age. It was also found that there are significant differences between constitutional types identified using the Pinier index in the overwhelming majority of the morphometric parameters studied. The obtained information has a significant clinical importance, since it will allow objectifying the diagnostic criteria of various vascular syndromes and minimizing the risk of endovascular interventions.

scholarly journals Vascular Structures of the Right Colon: Incidence and Variations with Their Clinical Implications

2016 ◽  
Vol 106 (2) ◽  
pp. 107-115 ◽  
Author(s):  
J. Alsabilah ◽  
W. R. Kim ◽  
N. K. Kim
Keyword(s):  
Colon Cancer ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Vascular Anatomy ◽  
Colic Artery ◽  
Right Colon ◽  
Right Colon Cancer ◽  
Vascular Structures ◽  
Gastrocolic Trunk ◽  
The Right

Background and Aims: There is a demand for a better understanding of the vascular structures around the right colonic area. Although right hemicolectomy with the recent concept of meticulous lymph node dissection is a standardized procedure for malignant diseases among most surgeons, variations in the actual anatomical vascular are not well understood. The aim of the present review was to present a detailed overview of the vascular variation pertinent to the surgery for right colon cancer. Materials and Methods: Medical literature was searched for the articles highlighting the vascular variation relevant to the right colon cancer surgery. Results: Recently, there have been many detailed studies on applied surgical vascular anatomy based on cadaveric dissections, as well as radiological and intraoperative examinations to overcome misconceptions concerning the arterial supply and venous drainage to the right colon. Ileocolic artery and middle colic artery are consistently present in all patients arising from the superior mesenteric artery. Even though the ileocolic artery passes posterior to the superior mesenteric vein in most of the cases, in some cases courses anterior to the superior mesenteric artery. The right colic artery is inconsistently present ranging from 63% to 10% across different studies. Ileocolic vein and middle colic vein is always present, while the right colic vein is absent in 50% of patients. The gastrocolic trunk of Henle is present in 46%–100% patients across many studies with variation in the tributaries ranging from bipodal to tetrapodal. Commonly, it is found that the right colonic veins, including the right colic vein, middle colic vein, and superior right colic vein, share the confluence forming the gastrocolic trunk of Henle in a highly variable frequency and different forms. Conclusion: Understanding the incidence and variations of the vascular anatomy of right side colon is of crucial importance. Failure to recognize the variation during surgery can result in troublesome bleeding especially during minimal invasive surgery.

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