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

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.

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

Journal of Morphological Sciences ◽

10.4322/jms.073914 ◽

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.

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Computed Tomography Angiography-Based Evaluation of Anatomical Variations of the Celiac ‎Trunk and Renal Arteries

International Journal of Medical Toxicology and Forensic Medicine ◽

10.32598/ijmtfm.v10i3.27797 ◽

2020 ◽

Vol 10 (3) ◽

pp. 27797

Author(s):

Sara Besharat ◽

Parima Safe ◽

Husain Karrabi ◽

Nasser Malekpour Alamdari

Keyword(s):

Computed Tomography ◽

Renal Artery ◽

Computed Tomography Angiography ◽

Celiac Trunk ◽

Anatomical Variations ◽

Left Gastric Artery ◽

Renal Arteries ◽

Gastric Artery ◽

Accessory Renal Artery ◽

Prevalent Form

Background: The abdominal aorta and its main branches, such as the celiac trunk and the renal arteries are manipulated during various radiologic, surgical, and oncologic procedures. This study aimed at evaluating the anatomical pattern of these vessels to assist surgeons and radiologists reduce the risk of intra- as well as postoperative complications. Methods: A retrospective analysis of 536 Computed Tomography Angiography (CTA) studies of living potential kidney donors was conducted from January 2012 to December 2018. Results: The anatomical variations of the celiac trunk was found in 9.5% of the cases. Among these cases, the most frequent variation was the Left Gastric Artery (LGA) as the first branch of the celiac trunk (80.4% of the cases). Gender was not overall significantly associated with the variations of the celiac trunk (P=0.670); however, there was a significant correlation between male gender and the most prevalent form of the celiac trunk variation (P=0.004). Variations of the renal artery occurred in 22.94% of the cases, with the left accessory renal artery being the most common variant (28.45% of the cases). Gender and the involved side (right/left) were not significantly related to the renal artery variations (P=1.000 & P=0.546, respectively). No concomitant variation of the celiac trunk and the renal artery was detected in our study. Conclusion: The anatomical variations of the celiac trunk and the renal arteries occur commonly; thus, the branching pattern of these arteries should be assessed prior to any procedure concerning them.

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Rare Anatomic Variation of Left Gastric Artery and Right Hepatic Artery in a Female Cadaver

The American Surgeon ◽

10.1177/000313480807400514 ◽

2008 ◽

Vol 74 (5) ◽

pp. 430-432

Author(s):

Theodore Troupis ◽

Stamatis Chatzikokolis ◽

Michael Zachariadis ◽

George Troupis ◽

Sofia Anagnostopoulou ◽

...

Keyword(s):

Hepatic Artery ◽

Present Report ◽

Anatomic Variation ◽

Celiac Trunk ◽

Left Gastric Artery ◽

Proper Hepatic Artery ◽

Gastric Artery ◽

Right Hepatic Artery ◽

Female Cadaver ◽

The Right

The present report describes a rare case in which the left gastric artery arises directly from the abdominal aorta and the right hepatic artery from the superior mesenteric artery, as observed during the dissection of a female cadaver. The left gastric artery usually rises as one of the three branches of the celiac trunk, which was originally described by Haller in 1756, whereas the right hepatic artery usually originates from the proper hepatic artery. The knowledge of the typical anatomy of the abdominal arteries, and their variations, is especially important due to the numerous interventions performed in the abdominal area.

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

Diagnostics ◽

10.3390/diagnostics11122262 ◽

2021 ◽

Vol 11 (12) ◽

pp. 2262

Author(s):

Kapil Kumar Malviya ◽

Ashish Verma ◽

Amit Kumar Nayak ◽

Anand Mishra ◽

Raghunath Shahaji More

Keyword(s):

Superior Mesenteric Artery ◽

Hepatic Artery ◽

Mesenteric Artery ◽

Celiac Trunk ◽

Left Gastric Artery ◽

Gastric Artery ◽

Inferior Phrenic Artery ◽

Abdominal Region ◽

Phrenic Artery ◽

Upper Abdominal

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.

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Anomalous Celiac Trunk Variation Encountered in Y-90 Radioembolization

Proceedings of IMPRS ◽

10.18060/24637 ◽

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.

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The Features of Extrahepatic Collateral Arteries Related to Hepatic Artery Occlusion and Benefits in the Transarterial Management of Liver Tumors

Radiology Research and Practice ◽

10.1155/2013/535272 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6

Author(s):

Lin Yang ◽

Xiao Ming Zhang ◽

Yong Jun Ren ◽

Nan Dong Miao ◽

Xiao Hua Huang ◽

...

Keyword(s):

Hepatic Artery ◽

Liver Tumors ◽

Left Gastric Artery ◽

Artery Occlusion ◽

Gastric Artery ◽

Collateral Arteries ◽

Hepatocellular Carcinomas ◽

Collateral Artery ◽

The Common ◽

The One

Purpose. To investigate the extrahepatic collateral arteries related to hepatic artery occlusion (HAO) and to determine its benefits in the transarterial management of liver tumors.Methods and Findings. Eleven patients (7 hepatocellular carcinomas, 3 liver metastases, and 1 with hemangioma) with HAO confirmed with digital subtraction angiography (DSA) were admitted to our hospital. Of the 11 patients, 7 were men and 4 were women, with an average age of 41.5 ± 15.5 years (range: 29 to 70 years). DSA was performed to evaluate the collateral routes to the liver. In the 11 patients with HAO, DSA showed complete occlusion of the common hepatic artery in 9 patients and the proper hepatic artery (PHA) in 2 patients. Extrahepatic collateral arteries supplying the liver were readily evident. The collateral arteries originated from the superior mesenteric artery (SMA) in 8 patients, from the gastroduodenal artery in 2 patients, and from the left gastric artery (LGA) in 1 patient. Transcatheter treatment was successfully performed via the collateral artery in all patients except the one who had hemangioma.Conclusions. DSA is an effective method for detecting collateral circulation related to HAO and may provide information to guide transcatheter management decisions.

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Clinical evaluation of the aberrant left hepatic artery arising from the left gastric artery in esophagectomy

Surgical and Radiologic Anatomy ◽

10.1007/s00276-018-2022-4 ◽

2018 ◽

Vol 40 (7) ◽

pp. 749-756 ◽

Cited By ~ 1

Author(s):

Harufumi Maki ◽

Hitoshi Satodate ◽

Shouichi Satou ◽

Kentaro Nakajima ◽

Atsuki Nagao ◽

...

Keyword(s):

Hepatic Artery ◽

Clinical Evaluation ◽

Left Gastric Artery ◽

Gastric Artery ◽

Left Hepatic Artery ◽

Aberrant Left Hepatic Artery

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Laparoscopic Left Gastric Artery-Preserving Subtotal Gastrectomy with D2 Lymphadenectomy in a Patient with Gastric Cancer and a Replaced Left Hepatic Artery

Videoscopy ◽

10.1089/vor.2020.0641 ◽

2020 ◽

Vol 30 (3) ◽

Author(s):

Ameet Kumar

Keyword(s):

Gastric Cancer ◽

Hepatic Artery ◽

Subtotal Gastrectomy ◽

Left Gastric Artery ◽

D2 Lymphadenectomy ◽

Gastric Artery ◽

Left Hepatic Artery

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Preserving a Rare Type of Variant Right Hepatic Artery Combines Surgical Radicality and Intact Liver Perfusion during Pancreatectomy

Visceral Medicine ◽

10.1159/000510484 ◽

2020 ◽

pp. 1-3

Author(s):

Ilgar Aghalarov ◽

Theodor Lutz ◽

Waldemar Uhl ◽

Orlin Belyaev

Keyword(s):

Hepatic Artery ◽

Preoperative Evaluation ◽

Liver Perfusion ◽

Pancreatic Head ◽

Celiac Trunk ◽

Left Gastric Artery ◽

Resection Margins ◽

R0 Resection ◽

Rare Type ◽

Right Hepatic Artery

An anomalous anatomy of the celiac trunk, and particularly of the right hepatic artery, may have a significant impact on major hepatobiliary and pancreatic surgery. According to some authors, every third patient has an aberrant right hepatic artery. We present a very rare case of replaced right hepatic artery (RRHA) arising from the gastroduodenal artery associated with an accessory left hepatic artery originating from the left gastric artery in a 54-year-old woman with a pancreatic head carcinoma. The patient underwent total pancreatectomy on account of a soft lipomatous pancreas with heterogeneous changes of the pancreatic body and tail. We preserved the RRHA and achieved R0 resection margins. Preoperative evaluation of CT angiograms, an awareness of any anomalous arterial anatomy of the upper abdomen, and a meticulous surgical technique are the key to performing oncologically radical surgery without threatening the arterial liver supply.

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