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 The origin of the inferior phrenic artery: a study in 32 South Indian cadavers with a review of the literature

2007 ◽  
Vol 6 (3) ◽  
pp. 225-230 ◽  
Author(s):  
Thejodhar Pulakunta ◽  
Bhagath Kumar Potu ◽  
Vasavi Rakesh Gorantla ◽  
Muddanna S. Rao ◽  
Sampath Madhyastha ◽  
...  
Keyword(s):  
Additional Data ◽  
Gross Anatomy ◽  
Celiac Trunk ◽  
Left Gastric Artery ◽  
Celiac Artery ◽  
Inferior Phrenic Artery ◽  
Medical College ◽  
South Indian ◽  
Phrenic Artery ◽  
The Right

BACKGROUND: Considering the paucity of information presently available concerning inferior phrenic arteries, a more definitive study seemed appropriate and necessary, both for its potential clinical applications and to provide additional data to contemporary anatomical literature. OBJECTIVE: Most anatomical textbooks of gross anatomy offer very little information concerning the anatomy and distribution of the inferior phrenic artery (IPA). For that reason, the origin of the IPA has been studied and the available literature has been reviewed. METHODS: Thirty-two human adult cadavers preserved in formalin obtained from the departments of Anatomy, Kasturba Medical College, Manipal and Mangalore were dissected and the origin of the IPA was studied. RESULTS: The IPA had its usual origin from the abdominal aorta in 28 cases but in the remaining four cases, two were arising from the celiac trunk, one from the left gastric artery and one from the right renal artery. CONCLUSION: The IPA usually originates from the aorta or celiac artery, and less frequently from the renal, hepatic or left gastric arteries. The IPA is a major source of collateral or parasitized arterial supply to hepatocellular carcinoma, second only to the hepatic artery. Literature on the IPA origin and clinical implications of variation in its origin have been reviewed in this article.

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

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.

Analysis of the origin of the right inferior phrenic artery in 178 patients with hepatocellular carcinoma treated by chemoembolization via the right inferior phrenic artery

2007 ◽  
Vol 48 (7) ◽  
pp. 728-733 ◽  
Author(s):  
S. Kimura ◽  
M. Okazaki ◽  
H. Higashihara ◽  
Y. Nozaki ◽  
M. Haruno ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Left Gastric Artery ◽  
Celiac Artery ◽  
Gastric Artery ◽  
Inferior Phrenic Artery ◽  
Pancreatic Artery ◽  
Phrenic Artery ◽  
The Right ◽  
Angiographic Findings ◽  
Arterial Chemoembolization

Background: No previous report has described the level of the origin of the right inferior phrenic artery (RIPA) based on an analysis of the relationships between the level of the RIPA, the celiac artery (CA), the superior mesenteric artery (SMA), and the right renal artery (RRA) in a series of cases. Purpose: To evaluate the origin of the RIPA by retrospectively analyzing angiographic findings in 178 patients with hepatocellular carcinoma (HCC) who underwent transcatheter arterial chemoembolization (TACE) via the RIPA. Material and Methods: In patients treated with intraarterial chemoembolization for HCC, additional superselective chemoembolization of the RIPA branches was necessary in 178 cases. We analyzed the level of the origin of the RIPA in these patients according to the relationships between the level of the origin of the RIPA, the CA, the SMA, and the RRA on angiography. Results: Among the 178 cases, the RIPA arose from 1) the aorta directly in 102 cases (57%), 2) the CA in 53 (30%), 3) the left gastric artery (LGA) in three (2%), 4) the dorsal pancreatic artery (DPA) in one (1%), and 5) the RRA in 19 (11%). The level of the origin of the RIPA that originated directly from the aorta was supraceliac in 56 cases (32%), between the CA and the SMA in 31 (17%), and between the SMA and the RRA in 15 (8%). Conclusion: In our study, the RIPA originated from the aorta between the CA and the SMA directly in 17% of cases. When it is difficult to identify the origin of the RIPA, we must keep in mind that the RIPA may originate from the right part of the aorta within the small distance between the SMA and the CA.

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 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 A Study of Anatomical Pattern of Inferior Phrenic Artery using Multidetector CT

2021 ◽  
Author(s):  
Anil Kumar Singh ◽  
Archna Gupta ◽  
Zafar Neyaz ◽  
Prabhakar Mishra
Keyword(s):  
Ct Angiography ◽  
Multidetector Ct ◽  
Uttar Pradesh ◽  
Celiac Trunk ◽  
Left Gastric Artery ◽  
Cross Sectional Study ◽  
Arterial Phase ◽  
Cross Sectional ◽  
Inferior Phrenic Artery ◽  
Phrenic Artery

Introduction: Inferior Phrenic Artery (IPA), though a small artery, is important from several points of view. Apart from being arterial supply to normal structures, it is also involved in many pathological conditions such as tumours, haemoptysis, gastroesophageal bleeding and traumatic conditions where interventional radiology or surgery play an important role in management. A preprocedure idea about variations in its anatomical pattern may help better treatment planning and minimise morbidity. Aim: To study variations in anatomical pattern of IPA in terms of vessel of origin, vertebral level of origin and diameter of IPA using Multidetector Computed Tomography (MDCT). Materials and Methods: The present study was a cross-sectional study conducted in Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India. A retrospective analysis of CT angiography or Triple phase CT abdomen studies of 200 adult patients (M:F 119:81) performed during December 2020 to April 2021 was done to look for anatomical pattern variations in IPA. Vessel of origin and level of origin were recorded. Diameters of IPAs were also recorded and statistical analysis was done. Results: Common Inferior Phrenic Artery (CIPA) was seen in 23% cases, with independent Right and Left Inferior Phrenic artery (RIPA and LIPA) in remaining 77%. Vessels of origin for CIPA were aorta (n=27; 58.7%), celiac trunk (n=16; 34.8%) and right Main Renal Artery (right MRA) (n=3; 6.5%); for RIPA, celiac trunk (n=69; 44.8%), aorta (n=57; 37.01%), right MRA (n=23;14.94%), Left Gastric Artery (LGA) (n=5; 3.25%), and for LIPA, celiac trunk (n=97; 63%), aorta (n=53; 34.4%), left MRA (n=2; 1.3%) and LGA (n=2; 1.3%), respectively. Level of origin from aorta for RIPA was L1>T12>T12/L1 disc>others; LIPA, T12>T12/L1>L1>others; celiac trunk, T12>L1>T12/L1 disc>others. Mean diameters of apparently normal RIPA and LIPA were 1.75 mm and 1.76 mm, respectively. Conclusion: The most common vessels of origin for CIPA, RIPA and LIPA were abdominal aorta (58.7%), celiac trunk (44.8%) and celiac trunk (63%), respectively. The predominant vertebral levels of origin for CIPA, RIPA and LIPA arising from aorta were T12, L1, and T12 respectively, and for celiac trunk T12. The mean diameter of IPA was found to be greatest in cirrhotic group followed by chronic pancreatitis and apparently normal IPA group, but not statistically significant. These can be efficiently and readily demonstrated by CT angiography or arterial phase of multiphasic CT study.

Diaphragmatic weakness after transcatheter arterial chemoembolization of the right inferior phrenic artery for treatment of hepatocellular carcinoma: a comparison of outcomes after N-butyl cyanoacrylate versus gelatin sponge embolization

2020 ◽  
pp. 028418512098177
Author(s):  
Seung Yeon Noh ◽  
Dong Il Gwon ◽  
Suyoung Park ◽  
Woo Jin Yang ◽  
Hee Ho Chu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Complete Response ◽  
Gelatin Sponge ◽  
Inferior Phrenic Artery ◽  
Gelatin Sponge Particles ◽  
Phrenic Artery ◽  
The Right ◽  
Diaphragmatic Weakness ◽  
Arterial Chemoembolization

Background The inferior phrenic artery (IPA) is the most common extrahepatic feeder for hepatocellular carcinoma (HCC) during transhepatic arterial chemoembolization (TACE). Purpose To compare the incidence of diaphragmatic weakness in patients with HCC after TACE of the right IPA conducted using either N-butyl cyanoacrylate (NBCA) or gelatin sponge particles. Material and Methods Medical records of 111 patients who underwent TACE of the right IPA using NBCA were retrospectively reviewed and compared with data from 135 patients with IPA embolization using gelatin sponge particles. Results The incidence of diaphragmatic weakness after the initial TACE procedure did not significantly differ between the groups (NBCA group 16.2%; gelatin sponge group 20.7%; P = 0.458). Five patients in the NBCA group and 11 in the gelatin sponge group showed spontaneous resolution of diaphragmatic weakness after a mean period of 3.5 months. Diaphragmatic weakness developed after the initial follow-up visit in 17 patients from the gelatin sponge group due to repeated TACE of the right IPA (mean 2.4 sessions; range 2–4 sessions), while it spontaneously developed without additional TACE procedures in one patient from the NBCA group. Permanent diaphragmatic weakness was less common in the NBCA than in the gelatin sponge group (12.6% and 25.2%, respectively; P = 0.017). The complete response rate did not significantly differ between the groups (NBCA group 16.2%; gelatin sponge group 25.9%; P = 0.065). Conclusion Use of NBCA rather than gelatin sponge particles for TACE of the right IPA resulted in a lower incidence of permanent diaphragmatic weakness.

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