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Case report
Published online: 2020-11-03
Submitted: 2020-08-19
Accepted: 2020-10-23
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Hepatomesenteric trunk, gastrosplenic trunk, coiled splenic and hepatic arteries, and a variant of Bühler's arc

M. Șelaru1, M. C. Rusu2, A. M. Jianu1, F. Bîrsășteanu1, B. A. Manta2
DOI: 10.5603/FM.a2020.0136
·
Pubmed: 33169353
Affiliations
  1. Department of Anatomy and Embryology, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
  2. Division of Anatomy, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

open access

Ahead of Print
CASE REPORTS
Published online: 2020-11-03
Submitted: 2020-08-19
Accepted: 2020-10-23

Abstract

The celiac trunk is normally divided into the left gastric artery (LGA), splenic artery (SA), and common hepatic artery (CHA). The combination between these arteries and the superior mesenteric artery (SMA) generates various combinations. We report here such a rare anatomic variant, namely the hepatomesenteric trunk (HMT), combined with a gastrosplenic trunk (GST). The variant was identified using computed tomography angiograms of a 62-years-old woman. The GST emerged from the aorta within the aortic hiatus of the diaphragm, a previously unknown possibility. Further, an accessory left hepatic artery originated from the LGA. The phrenic arteries had independent aortic origins. The HMT divided into the CHA and the SMA posterior to the origin of the hepatic portal vein (PV), above the pancreas. The CHA initially had a right course, towards the superior border of the PV, then it descended with a transpancreatic course posterior to the PV, reached its inferior/right border, and divided antero-inferiorly to the PV into the proper hepatic (PHA) and gastroduodenal arteries. The PHA continued on the anterior side of the PV, sending off the left and right hepatic arteries. The HMT and the GST were connected by a rudimentary variant of the arc of Bühler, unreported previously. Arterial variations in the celiac region are accurately distinguished on computed tomography angiograms. They should be evaluated by surgeons when different surgical procedures are evaluated.

Abstract

The celiac trunk is normally divided into the left gastric artery (LGA), splenic artery (SA), and common hepatic artery (CHA). The combination between these arteries and the superior mesenteric artery (SMA) generates various combinations. We report here such a rare anatomic variant, namely the hepatomesenteric trunk (HMT), combined with a gastrosplenic trunk (GST). The variant was identified using computed tomography angiograms of a 62-years-old woman. The GST emerged from the aorta within the aortic hiatus of the diaphragm, a previously unknown possibility. Further, an accessory left hepatic artery originated from the LGA. The phrenic arteries had independent aortic origins. The HMT divided into the CHA and the SMA posterior to the origin of the hepatic portal vein (PV), above the pancreas. The CHA initially had a right course, towards the superior border of the PV, then it descended with a transpancreatic course posterior to the PV, reached its inferior/right border, and divided antero-inferiorly to the PV into the proper hepatic (PHA) and gastroduodenal arteries. The PHA continued on the anterior side of the PV, sending off the left and right hepatic arteries. The HMT and the GST were connected by a rudimentary variant of the arc of Bühler, unreported previously. Arterial variations in the celiac region are accurately distinguished on computed tomography angiograms. They should be evaluated by surgeons when different surgical procedures are evaluated.

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Keywords

aorta, celiac trunk, superior mesenteric artery, computed tomography, hepatic artery

About this article
Title

Hepatomesenteric trunk, gastrosplenic trunk, coiled splenic and hepatic arteries, and a variant of Bühler's arc

Journal

Folia Morphologica

Issue

Ahead of Print

Article type

Case report

Published online

2020-11-03

DOI

10.5603/FM.a2020.0136

Pubmed

33169353

Keywords

aorta
celiac trunk
superior mesenteric artery
computed tomography
hepatic artery

Authors

M. Șelaru
M. C. Rusu
A. M. Jianu
F. Bîrsășteanu
B. A. Manta

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