Types of coeliac trunk branching including accessory hepatic arteries: a new point of view based on cadaveric study
Abstract
Background: The coeliac trunk (CT) is major visceral branch of the abdominal aorta. Familiarity with anatomic variations of the CT is relevant for planning radiological and surgical procedures. The aim of our research was determining variations of the CT, including the occurrence of accessory hepatic arteries (AHA). Materials and methods: Forty cadavers were studied. Six patterns of CT branching were observed in this study. AHA were observed in 7 (17.5%) specimens. The most prevalent variation was normal trifurcation, accounting for 62.5% of cases. The rarest variation was absence of the CT, with an incidence of 2.5%. In this variant the left gastric artery, the common hepatic artery, and the splenic artery branched directly off the abdominal aorta. Results: The study material allowed to distinguish two CT branching patterns which, to the best of our knowledge, have not been reported before. It was a type with four branches originating from the CT: the left gastric artery, the common hepatic artery, the splenic artery, and right AHA. The other previously unreported pattern variant was the CT which gave off three branches: the common hepatic artery, the splenic artery and right AHA. Conclusions: The average distance between the aortic hiatus and the coeliac trunk calculated for all the cadavers amounted to 54 ± 11.85 mm. The average distance between the CT and the superior mesenteric artery was 11.1 ± 7.7 mm.
Keywords: anatomical variationsaccessory hepatic arterycoeliac trunkhepatosplenic trunkleft gastric artery
References
- Adachi B, Hasebe K. Das Arteriensystem der Japaner, Anatomie der Japaner. Kaiserlich-japanische Universität zu Kyoto. In kommission bei Maruzen Co., Kyoto and Tokyo 1928.
- Araujo Neto SA, Franca HA, de Mello Júnior CF, et al. Anatomical variations of the celiac trunk and hepatic arterial system: an analysis using multidetector computed tomography angiography. Radiol Bras. 2015; 48(6): 358–362.
- Babu ED, Khrab P. Coeliac trunk variations: review with proposed new classification. Int J Anat Res. 2013; 1(3): 165–170.
- Bergman RA, Afifi AK, Miyauchi R. llustrated encyclopaedia of human anatomic variation. http://www.anatomyatlases.org/AnatomicVariants/AnatomyHP.shtml (accessed Feb 2017).
- Chen H, Yano R, Emura S, et al. Anatomic variation of the celiac trunk with special reference to hepatic artery patterns. Ann Anat. 2009; 191(4): 399–407.
- Hiatt JR, Gabbay J, Busuttil RW. Surgical anatomy of the hepatic arteries in 1000 cases. Ann Surg. 1994; 220(1): 50–52.
- Lipshutz B. A composite study of the coeliac axis artery. Ann Surg. 1917; 65(2): 159–169.
- Michels NA. Newer anatomy of the liver and its variant blood supply and collateral circulation. Am J Surg. 1966; 112(3): 337–347.
- Olewnik Ł, Wysiadecki G, Polguj M, et al. A rare anastomosis between the common hepatic artery and the superior mesenteric artery: a case report. Surg Radiol Anat. 2017 [Epub ahead of print].
- Polguj M, Gabryniak T, Topol M. The right accessory hepatic artery; a case report and review of the literature. Surg Radiol Anat. 2010; 32(2): 175–179.
- Pushpalatha K. Study of origin, lengh, diameter and branches of the coeliac trunk and its surgiacal significance. Thesis, Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore 2006. http://14.139.159.4:8080/jspui/bitstream/123456789/4316/1/CDMANT00018.pdf (accessed Feb 2017).
- Prakash, Rajini T, Mokhasi V, Geethanjali BS, et al. Coeliac trunk and its branches: anatomical variations and clinical implications. Singapore Med J. 2012; 53(5): 329–331.
- Sebben GA, Rocha SL, Sebben MA, et al. Variations of hepatic artery: anatomical study on cadavers. Rev Col Bras Cir. 2013; 40(3): 221–226.
- Selvaraj L, Sundaramurthi I. Study of Normal Branching Pattern of the Coeliac Trunk and its Variations Using CT Angiography. J Clin Diagn Res. 2015; 9(9): AC01–AC04.
- Singh BGP, Bhatt CR, Patel SV, et al. Morphometric study of coeliac trunk specific reference to hepatic artery pattern in the west-indian population. Indian J Surg. 2014; 76(5): 359–362.
- Song SY, Chung JW, Yin YHu, et al. Celiac axis and common hepatic artery variations in 5002 patients: systematic analysis with spiral CT and DSA. Radiology. 2010; 255(1): 278–288.
- Standring S. Gray’s Anatomy: The Anatomical Basis of Clinical Practice, 40th ed. Churchill Livingstone, Edinburgh and London 2008.
- Ugurel MS, Battal B, Bozlar U, et al. Anatomical variations of hepatic arterial system, coeliac trunk and renal arteries: an analysis with multidetector CT angiography. Br J Radiol. 2010; 83(992): 661–667.
- Wadhwa A, Sonia SA. composite study of coeliac trunk in 30 adult human cadavers – its clinical implications. Glob J Med Res. 2011; 11(1): 35–38.