open access

Vol 80, No 2 (2021)
Case report
Submitted: 2020-03-22
Accepted: 2020-04-29
Published online: 2020-05-18
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Rare combined variations of the coeliac trunk, accessory hepatic and gastric arteries with co-occurrence of double cystic arteries

A. Mazurek1, A. Juszczak1, J. A. Walocha1, A. Pasternak1
·
Pubmed: 32459367
·
Folia Morphol 2021;80(2):460-466.
Affiliations
  1. Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland

open access

Vol 80, No 2 (2021)
CASE REPORTS
Submitted: 2020-03-22
Accepted: 2020-04-29
Published online: 2020-05-18

Abstract

Many variations of the coeliac trunk and hepatic or gallbladder arterial supply have been reported before in many cadaveric and radiologic studies. In this case we present combined anomalies observed in dissected cadaver of a 73-year-old female. The left gastric artery arises directly from the abdominal aorta and gives two branches: the right inferior phrenic artery in the proximal part and the accessory left hepatic artery in the distal part. The coeliac trunk is bifurcated into the common hepatic artery and the splenic artery. The right gastric artery emerges from the left hepatic artery. The right hepatic artery gives two cystic arteries and the accessory right hepatic artery is noticed arising from the posterior superior pancreaticoduodenal artery. The deep cystic artery and the right inferior phrenic artery give hepatic branches. Also, we noticed small accessory biliary duct going to the cystic duct. This complexity of the arterial supply with anomaly of the biliary ducts has many surgical implications which will be herein discussed.

Abstract

Many variations of the coeliac trunk and hepatic or gallbladder arterial supply have been reported before in many cadaveric and radiologic studies. In this case we present combined anomalies observed in dissected cadaver of a 73-year-old female. The left gastric artery arises directly from the abdominal aorta and gives two branches: the right inferior phrenic artery in the proximal part and the accessory left hepatic artery in the distal part. The coeliac trunk is bifurcated into the common hepatic artery and the splenic artery. The right gastric artery emerges from the left hepatic artery. The right hepatic artery gives two cystic arteries and the accessory right hepatic artery is noticed arising from the posterior superior pancreaticoduodenal artery. The deep cystic artery and the right inferior phrenic artery give hepatic branches. Also, we noticed small accessory biliary duct going to the cystic duct. This complexity of the arterial supply with anomaly of the biliary ducts has many surgical implications which will be herein discussed.

Get Citation

Keywords

anatomical variations, accessory hepatic artery, gastric artery, double cystic arteries, right inferior phrenic artery

About this article
Title

Rare combined variations of the coeliac trunk, accessory hepatic and gastric arteries with co-occurrence of double cystic arteries

Journal

Folia Morphologica

Issue

Vol 80, No 2 (2021)

Article type

Case report

Pages

460-466

Published online

2020-05-18

Page views

1119

Article views/downloads

1173

DOI

10.5603/FM.a2020.0052

Pubmed

32459367

Bibliographic record

Folia Morphol 2021;80(2):460-466.

Keywords

anatomical variations
accessory hepatic artery
gastric artery
double cystic arteries
right inferior phrenic artery

Authors

A. Mazurek
A. Juszczak
J. A. Walocha
A. Pasternak

References (37)
  1. Adachi B. Das Arteriensystem der Japaner, vol II. Maruzen, Kyoto 1928: 16–64.
  2. Ahn CS, Lee SG, Hwang S, et al. Anatomic variation of the right hepatic artery and its reconstruction for living donor liver transplantation using right lobe graft. Transplant Proc. 2005; 37(2): 1067–1069.
  3. Andall RG, Matusz P, du Plessis M, et al. The clinical anatomy of cystic artery variations: a review of over 9800 cases. Surg Radiol Anat. 2016; 38(5): 529–539.
  4. Aslaner R, Pekcevik Y, Sahin H, et al. Variations in the origin of inferior phrenic arteries and their relationship to celiac axis variations on CT angiography. Korean J Radiol. 2017; 18(2): 336–344.
  5. Basile A, Tsetis D, Montineri A, et al. MDCT anatomic assessment of right inferior phrenic artery origin related to potential supply to hepatocellular carcinoma and its embolization. Cardiovasc Intervent Radiol. 2008; 31(2): 349–358.
  6. Browne EZ. Variations in origin and course of the hepatic artery and its branches. Surgery. 1940; 8: 424–445.
  7. Calot JF. De la cholecystecomie. Dissertation, Med Frc de Paris 1891.
  8. Catalano OA, Singh AH, Uppot RN, et al. Vascular and biliary variants in the liver: implications for liver surgery. Radiographics. 2008; 28(2): 359–378.
  9. Cirocchi R, D'Andrea V, Amato B, et al. Aberrant left hepatic arteries arising from left gastric arteries and their clinical importance. Surgeon. 2020; 18(2): 100–112.
  10. Dolenšek J. Triple arterial blood supply to the liver and double cystic arteries. Folia Morphol. 2017; 76(3): 523–526.
  11. Eckmann I, Krahn V. [Frequency of different sites of origin of the right gastric artery]. Anat Anz. 1984; 155(1-5): 65–70.
  12. Fang C, Yan S, Zheng S. Bile Leakage after Liver Transplantation. Open Med (Wars). 2017; 12: 424–429.
  13. Favelier S, Germain T, Genson PY, et al. Anatomy of liver arteries for interventional radiology. Diagn Interv Imaging. 2015; 96(6): 537–546.
  14. Gurgacz AM, Horbaczewska A, Klimek-Piotrowska W, et al. Variations in hepatic vascularisation: lack of a proper hepatic artery. Two case reports. Folia Morphol. 2011; 70(2): 130–134.
  15. Hiatt JR, Gabbay J, Busuttil RW. Surgical anatomy of the hepatic arteries in 1000 cases. Ann Surg. 1994; 220(1): 50–52.
  16. Hirai Y, Yamaki K, Saga T, et al. An anomalous case of the hepato-spleno-mesenteric and the gastro-phrenic trunks independently arising from the abdominal aorta. Kurume Med J. 2000; 47(2): 189–192.
  17. Jin W, Dong M, Pan J, et al. Rare combined variations of accessory left hepatic artery and accessory right hepatic artery: a case report and literature review. Surg Radiol Anat. 2020; 42(4): 443–447.
  18. Juszczak A, Solewski B, Loukas M, et al. Unusual branching pattern of celiac trunk associated with supernumerary hepatic arteries and abnormal adrenal venous drainage - case study and review of the literature. Folia Med Cracov. 2017; 57(3): 29–36.
  19. Kim HC, Chung JW, Lee W, et al. Recognizing extrahepatic collateral vessels that supply hepatocellular carcinoma to avoid complications of transcatheter arterial chemoembolization. Radiographics. 2005; 25 Suppl 1: S25–S39.
  20. Loukas M, Fergurson A, Louis RG, et al. Multiple variations of the hepatobiliary vasculature including double cystic arteries, accessory left hepatic artery and hepatosplenic trunk: a case report. Surg Radiol Anat. 2006; 28(5): 525–528.
  21. Mahajan A, Tiwari S, Mishra S. A Unique Conglomeration of Variations in the Celiac, Hepatic, and Superior Mesenteric Artery: A Clinico-Embryological Perspective. Int J Appl Basic Med Res. 2018; 8(4): 256–258.
  22. Matusz P, Loukas M, Iacob N, et al. Common stem origin of left gastric, right and left inferior phrenic arteries, in association with a hepatosplenomesenteric trunk, independently arising from the abdominal aorta: case report using MDCT angiography. Clin Anat. 2013; 26(8): 980–983.
  23. Michels NA. Newer anatomy of the liver and its variant blood supply and collateral circulation. Am J Surg. 1966; 112(3): 337–347.
  24. Mizumoto R, Suzuki H. Surgical anatomy of the hepatic hilum with special reference to the caudate lobe. World J Surg. 1988; 12(1): 2–10.
  25. Olewnik Ł, Waśniewska A, Polguj M, et al. Rare combined variations of renal, suprarenal, phrenic and accessory hepatic arteries. Surg Radiol Anat. 2018; 40(7): 743–748.
  26. Piao DX, Ohtsuka A, Murakami T. Typology of abdominal arteries, with special reference to inferior phrenic arteries and their esophageal branches. Acta Med Okayama. 1998; 52(4): 189–196.
  27. Polguj M, Podgórski M, Hogendorf P, et al. Variations of the hepatobiliary vasculature including coexistence of accessory right hepatic artery with unusually arising double cystic arteries: case report and literature review. Anat Sci Int. 2014; 89(3): 195–198.
  28. Prasanna LC, Alva R, Sneha GK, et al. Rare variations in the origin, branching pattern and course of the celiac trunk: report of two cases. Malays J Med Sci. 2016; 23(1): 77–81.
  29. Schnelldorfer T, Sarr MG, Adams DB. What is the duct of Luschka? A systematic review. J Gastrointest Surg. 2012; 16(3): 656–662.
  30. Schofield A, Hankins J, Sutherland F. A case of cholecystohepatic duct with atrophic common hepatic duct. HPB (Oxford). 2003; 5(4): 261–263.
  31. Spanos CP, Syrakos T. Bile leaks from the duct of Luschka (subvesical duct): a review. Langenbecks Arch Surg. 2006; 391(5): 441–447.
  32. Terayama H, Yi SQ, Tanaka O, et al. Common and separate origins of the left and right inferior phrenic artery with a review of the literature. Folia Morphol. 2017; 76(3): 408–413.
  33. Wang Yi, Cheng C, Wang Lu, et al. Anatomical variations in the origins of the celiac axis and the superior mesenteric artery: MDCT angiographic findings and their probable embryological mechanisms. Eur Radiol. 2014; 24(8): 1777–1784.
  34. Watson CJE, Harper SJF. Anatomical variation and its management in transplantation. Am J Transplant. 2015; 15(6): 1459–1471.
  35. Whitley A, Oliverius M, Kocián P, et al. Variations of the celiac trunk investigated by multidetector computed tomography: Systematic review and meta-analysis with clinical correlations. Clin Anat. 2020; 33(8): 1249–1262.
  36. Yamagami T, Nakamura T, Iida S, et al. Embolization of the right gastric artery before hepatic arterial infusion chemotherapy to prevent gastric mucosal lesions: approach through the hepatic artery versus the left gastric artery. Am J Roentgenol. 2002; 179(6): 1605–1610.
  37. Yi SQ, Li J, Terayama H, et al. A rare case of inferior mesenteric artery arising from the superior mesenteric artery, with a review of the review of the literature. Surg Radiol Anat. 2008; 30(2): 159–165.

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