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 Rare Anatomic Variation: The Hepatosplenomesentericophrenic Trunk

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 170
Author(s):  
Bogdan Gheorghe Hogea ◽  
Mugurel Constantin Rusu ◽  
Adelina Maria Jianu ◽  
Bogdan Adrian Manta ◽  
Adrian Cosmin Ilie
Keyword(s):  
Anatomic Variation ◽  
Celiac Trunk ◽  
Left Gastric Artery ◽  
Gastric Artery ◽  
Inferior Phrenic Artery ◽  
Phrenic Artery ◽  
Anatomic Variants ◽  
The Right ◽  
Rare Anatomic Variant ◽  
Anatomic Feature

The rare anatomic variants of the celiac trunk and superior mesenteric artery include the hepatosplenic, hepatosplenomesenteric (HSMT), celiacomesenteric, hepatomesenteric and gastrosplenic trunks. We report a 72-year-old female patient whose computed tomography angiograms indicated a rare anatomic feature whereby the right inferior phrenic artery was inserted in the origin of an HSMT, thus modifying it into a hepatosplenomesentericophrenic trunk (HSMPT). Above the HSMPT, the insertion of the left inferior phrenic artery in the origin of the left gastric artery determined a left gastrophrenic trunk (GPT). Proper identification of this type of rare anatomic variant is of utmost importance prior to different surgical procedures. For example, an HSMT origin of the right inferior phrenic artery is surgically relevant if this artery is an extrinsic pedicle of a hepatocellular carcinoma and is used for embolization of the tumor.

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 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.

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.

The Arterial Vascular Supply of the Upper Abdominal Organs in the Rat

1984 ◽  
Vol 35 (3) ◽  
pp. 455-468 ◽  
Author(s):  
A.B. Boekelaar ◽  
B. Baljet ◽  
J. Drukker
Keyword(s):  
Hepatic Artery ◽  
Splenic Artery ◽  
Left Gastric Artery ◽  
Vascular Supply ◽  
Gastroduodenal Artery ◽  
Greater Omentum ◽  
Gastric Artery ◽  
Abdominal Organs ◽  
Upper Abdominal ◽  
Hepatic Artery Proper

In this study the arterial vascular supply of the upper abdominal organs in the rat was investigated. In general the main anatomical features seem to be in accordance with the anatomy in man. However there are some important differences worth mentioning and the nomenclature used in the rat is not adequate in all respects: 1. The branch of the celiac artery which bifurcates into the hepatic artery proper and the gastroduodenal artery should not be given the incorrect name hepatic artery but is named common hepatic artery. 2. The hepato-esophageal artery is a constantly present branch of the hepatic artery proper running in the hepatogastric ligament. 3. The right gastric artery, present in about 40% of the specimens, is a branch of the gastroduodenal artery which runs towards the lesser curvature where it communicates freely with a left gastric artery branch. 4. The gastrosplenic artery is one of the branches of the splenic artery. It divides into a gastric and a splenic branch. The gastric branch is the only short gastric artery present in the rat. 5. A gastro-epiploic artery at the splenic side of the stomach is not present in the rat. The continuation of the splenic artery into the greater omentum has been referred to as the left epiploic artery. Anastomoses with epiploic branches of the gastro-epiploic artery are present in the greater omentum.

scholarly journals Anatomy of the vasculature supplying hepatobiliary structures and celiac trunk branching patterns in the Thai population

2019 ◽  
Vol 12 (4) ◽  
pp. 161-167
Author(s):  
Natcha Nateniyom ◽  
Thanasil Huanmanop ◽  
Sithiporn Agthong ◽  
Vilai Chentanez
Keyword(s):  
Hepatic Artery ◽  
Hepatic Duct ◽  
Celiac Trunk ◽  
Left Gastric Artery ◽  
Vascular Supply ◽  
Common Hepatic Duct ◽  
Branching Pattern ◽  
Thai Population ◽  
Branching Patterns ◽  
Upper Abdominal

AbstractBackgroundKnowledge of the anatomy of the celiac trunk (CT) and arterial supply of the hepatobiliary system is essential for surgical and interventional radiological treatment of upper abdominal diseases.ObjectivesTo determine the branching patterns of the CT and variation in origin and type of the right hepatic artery (RHA), left hepatic artery (LHA), and cystic artery (CA).MethodsThe anatomy of the CT in 100 cadavers from Thai adult donors was observed in 3 aspects: its branching pattern, the origin of the RHA and LHA, and the origin of the CA and its relation to the common bile duct (CBD) and common hepatic duct (CHD).ResultsThe majority of the CT branching pattern was categorized as the type II classical pattern, which has 3 branches: the left gastric artery (LGA), splenic artery (SA), and common hepatic artery (CHA). The RHA branched from proper hepatic artery in 67 cadavers. The origin of the accessory RHA was either from the abdominal aorta or superior mesenteric artery (SMA), whereas the replaced RHA originated from the CHA, SMA, or CT. The accessory LHA ramified from CHA (2 cases) and LGA (1 case). The replaced LHA was found in 30 cadavers and 29 arose from the CHA. The single and double types of CA were found in 94 and 4 cadavers, respectively. In all, 57% of single CA passed posteriorly and 39% passed anteriorly to the CBD and CHD.ConclusionsTo lower posttreatment complications, variations in the anatomy and the vascular supply of hepatobiliary structures should be considered.

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 Extra coeliac axis origin of cystic artery: a cadaveric study

2017 ◽  
Vol 06 (03) ◽  
pp. 184-187
Author(s):  
◽  
Keyword(s):  
Superior Mesenteric Artery ◽  
Hepatic Artery ◽  
Mesenteric Artery ◽  
Arterial Embolization ◽  
Cystic Artery ◽  
Medical College ◽  
Right Hepatic Artery ◽  
Coeliac Trunk ◽  
Upper Abdominal ◽  
Formalin Fixed

Abstract Background: A thorough knowledge of extra hepatic biliary system vasculature is very important for surgeons to avoid iatrogenic bleeding during upper abdominal surgeries. Aim: Cystic artery usually a branch of right hepatic artery rarely has anomalous origin from coeliac trunk or from its branches. Very rarely it has an extracoeliac origin. The aim is to study the incidence of origin of cystic artery other than coeliac trunk. Material and method: The study was done on 50 formalin fixed cadavers [32male, 18 female] in the department of anatomy, Bangalore medical college and research institute during 2014-17. During routine dissection of coeliac trunk, cystic artery was traced and observed for its origin. Results: Cystic artery took its origin from right hepatic artery in 37 [74%], left hepatic artery in 9[18%], hepatic artery in 3[6%] and superior mesenteric artery ini [2%] cadaver. Conclusion: The incidence of extra coeliac axis origin of cystic artery is 2% which arose from superior mesenteric artery. Prior knowledge of these variations is important for surgeons and interventional radiologists during pancreatobiliary surgeries, angiogram and arterial embolization.

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