scholarly journals Peculiarities of Extra-Organic Variant Anatomy of the Celiac Trunk and Hepatic Artery in Patients with Liver Cancer

2018 ◽  
Vol 8 (2) ◽  
pp. 19-26
Author(s):  
B. V. Besedin ◽  
K. Sh. Gantsev ◽  
D. T. Arybzhanov ◽  
A. U. Kaskabayev
Keyword(s):  
Liver Cancer ◽  
Superior Mesenteric Artery ◽  
Hepatic Artery ◽  
Mesenteric Artery ◽  
Primary Liver Cancer ◽  
Celiac Trunk ◽  
Vascular Reconstruction ◽  
Left Gastric Artery ◽  
Type 3

Introduction. Knowledge of the different variants of the structure of the celiac trunk and the hepatic artery is of great importance in the planning, treatment and choice of approaches for transcatheter vascular interventions.Objective: to study features of variant hematopoietic anatomy from direct and multispiral computed tomography angiography (MSCTA) data in order to determine its significance in routine clinical practice.Materials and methods. We analysed the most common variants of branching of the celiac trunk and anatomy of the hepatic artery according to direct angiography and MSCTA data in 112 patients with primary liver cancer. The sample comprised 71 men (63.3 %) and 41 women (36.7 %).Results and discussion. It was found that the most frequent aberration was the passage of the replacement right hepatic artery from the superior mesenteric artery — type 3 according to N. Michels. The second aberration in terms of frequency was Michels type 2. We describe two unusual celiac trunk and hepatic anatomy variants: the first of these comprising a celiac trunk 22 cm long extending from the superior mesenteric artery; the second consisting in a complete absence of the celiac trunk, with all its elements (left gastric artery, common hepatic artery and splenic artery) departing independently from the abdominal aorta.Conclusions. A typical anatomy of the celiac trunk and hepatic artery was found in 60 % of cases, the most frequent aberration being the Michels type 3, noted in 14.2 % of patients, and type 2 noted in 9.8 % of patients. Knowledge of individual blood supply features largely determines the procedure for conducting operations, permitting purposeful intraoperative revision and the selection of the optimal vascular reconstruction variant, and avoiding damage to aberrant arteries. 

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

Diagnostics ◽  
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.

scholarly journals Pattern analysis and distribution of the superior mesenteric artery branches in corpses in a death survey service

2016 ◽  
Vol 33 (01) ◽  
pp. 001-004
Author(s):  
A. Pereira ◽  
S. Aires Neto ◽  
E. Silva Neto ◽  
H. Franca ◽  
G. Negromonte ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Ethnic Groups ◽  
Mesenteric Artery ◽  
Standard Type ◽  
Variation Patterns ◽  
Statistical Program ◽  
Type 3 ◽  
Normal Standard

Abstract Introduction: The distribution pattern of the superior mesenteric artery (SMA) varies in the studies described by the literature. Objectives: To establish the variation pattern for the Brazilian population as well as to compare this distribution according to sex and ethnic groups. Materials and Methods: A total of 41 corpses were dissected in the Death Survey Service of Paraiba (SVO/PB), and the variation patterns were analyzed by comparing sex and ethnic groups by means of the statistical program SPSS 21.0. Results and Conclusion: From the 41 dissected corpses, 43,9%, n=18 were classified as normal, standard type 1, 7,3%, n=3, standard type 2, 24,3%, n=10, standard type 3, 14,6%, n=6, standard type 4, 9,7%, n=4, standard type 5, 9,7%, n=4. Statistically significant variations of the SMA patterns in relation to sex and ethnic groups were not found. The described patterns should be verified in order to inform and lead the health professionals in relation to the patient's care, especially in the surgical scope.

scholarly journals Сlinical case of pancreatic cancer

2019 ◽  
Vol 44 (3) ◽  
pp. 50-53
Author(s):  
M. Kankia ◽  
I. Jikia ◽  
G. Mtskherashvili ◽  
G. Cucxubaia
Keyword(s):  
Superior Mesenteric Artery ◽  
Hepatic Artery ◽  
Mesenteric Artery ◽  
Vena Cava ◽  
Celiac Trunk ◽  
Ductal Adenocarcinoma ◽  
Right Hepatic Artery ◽  
Ligament Of Treitz ◽  
Normal Blood Flow ◽  
Pancreas Body

Description of a rare case of pancreas body tumor, which was grown into celiac trunk, is presented. The patient was saved due toanftomy of right hepatic artery, which was a branch of superior mesenteric artery. Patient Z.V, 60 years old, came to the clinic with such complaints as pain, heaviness in abdomen and waist area,weakness.4–5 cm tumor of pancreas body was detectedduring surgery. The tumor had grown into celiac trunk and into left adrenal gland. The friable tissue of hepato-duodenal ligament was dissected duringthe surgery.Thesurgeons mobilized duodenum usingKoxertechnique. As a result of this manipulation, the followingblood vesselswere visualized:inferior vena cava and abdominal aorta, celiac trunk, superior mesentericartery. Surgical team opened ligament of Treitz and excisedpancreas body2.5 cm away from thetumor proximally. The stump was sewed with “mattress stich”, celiac trunk was sectioned and entangled, surgeons also dissected common hepatic artery. After section they checked blood supply of liver. The pressure of blood flowing from gastro-duodenal and pancreato-duodenal artery was enough for providing normal blood flow in the left hepatic artery. Morphological result of the excisedtissue — Ductal adenocarcinoma (No 672). The patient’sstate was satisfactory when he left the clinic. He underwent medical check-up three times next year. He feels well, his state of health is normal. Patient is capable of working. This case is interesting due to the anatomy of right hepatic artery (which was a branch of superior mesenteric artery) that saved patient’s life.

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.

scholarly journals ANATOMIC VARIATIONS OF HEPATIC ARTERY: A STUDY IN 479 LIVER TRANSPLANTATIONS

2017 ◽  
Vol 30 (1) ◽  
pp. 35-37 ◽  
Author(s):  
Olival Cirilo Lucena da FONSECA-NETO ◽  
Heloise Caroline de Souza LIMA ◽  
Priscylla RABELO ◽  
Paulo Sérgio Vieira de MELO ◽  
Américo Gusmão AMORIM ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Hepatic Artery ◽  
Mesenteric Artery ◽  
Left Gastric Artery ◽  
Type Ii ◽  
Gastric Artery ◽  
Left Hepatic Artery ◽  
Hepatic Artery Branch ◽  
Arterial Anatomy ◽  
Artery Branch

ABSTRACT Background: The incidence of anatomic variations of hepatic artery ranges from 20-50% in different series. Variations are especially important in the context of liver orthotopic transplantation, since, besides being an ideal opportunity for surgical anatomical study, their precise identification is crucial to the success of the procedure. Aim: To identify the anatomical variations in the hepatic arterial system in hepatic transplantation. Methods: 479 medical records of transplanted adult patients in the 13-year period were retrospectively analyzed, and collected data on hepatic arterial anatomy of the deceased donor. Results: It was identified normal hepatic arterial anatomy in 416 donors (86.84%). The other 63 patients (13.15%) showed some variation. According to the Michels classification, the most frequently observed abnormalities were: right hepatic artery branch of superior mesenteric artery (Type III, n=27, 5.63%); left hepatic artery branch of the left gastric artery (Type II, n=13, 2.71%); right hepatic artery arising from the superior mesenteric artery associated with the left hepatic artery arising from the left gastric artery (Type IV, n=4, 0.83%). Similarly, in relation to Hiatt classification, the most prevalent changes were: right hepatic accessory artery or substitute of the superior mesenteric artery (Type III, n=28, 6.05%)), followed by liver ancillary left artery or replacement of gastric artery left (Type II, n=16, 3.34. Fourteen donors (2.92%) showed no anatomical abnormalities defined in classifications, the highest frequency being hepatomesenteric trunk identified in five (01.04%). Conclusion: Detailed knowledge of the variations of hepatic arterial anatomy is of utmost importance to surgeons who perform approaches in this area, particularly in liver transplantation, since their identification and proper management are critical to the success of the procedure.

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.

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 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.

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