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Vol 80, No 2 (2021)
Original article
Submitted: 2020-04-23
Accepted: 2020-06-07
Published online: 2020-06-09
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Unusual variations in the branching pattern of the coeliac trunk and their clinical significance

A. Juszczak1, J. Czyżowski2, A. Mazurek1, J. A. Walocha1, A. Pasternak1
DOI: 10.5603/FM.a2020.0067
·
Pubmed: 32639575
·
Folia Morphol 2021;80(2):283-289.
Affiliations
  1. Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
  2. Institute of Diagnostic Imaging, J. Dietl Specialist Hospital, Krakow, Poland

open access

Vol 80, No 2 (2021)
ORIGINAL ARTICLES
Submitted: 2020-04-23
Accepted: 2020-06-07
Published online: 2020-06-09

Abstract

Background: The anatomical variations of the coeliac trunk are due to developmental changes in the ventral segmental arteries. Multidetector computed tomography (MDCT) has been used to investigate vascular anatomy for scientific and diagnostic purposes. These studies allow for much larger sample sizes than traditional cadaveric studies. The aim of this research was to isolate rare anatomical variants of the coeliac trunk and emphasize their clinical significance.

Materials and methods: A descriptive, retrospective study was carried out on MDCT angiographies performed from January 2020 till March 2020 in Polish patients. Coeliac trunk was studied and normal and anatomical variations were identified.

Results: Out of total 350 patients, hepatogastrosplenic trunk was predominant. However, we observed: coeliaco-mesenteric and hepatogastric trunk type, hepatic artery variations and coeliac axis stenosis with collateral mesenteric circulation.

Conclusions: Rare variations of the coeliac trunk should always be anticipated before radiological and surgical interventions. Knowledge of unusual coeliac trunk anatomy is important in hepatopancreatobiliary surgery, transplantology, and interventional radiology.

Abstract

Background: The anatomical variations of the coeliac trunk are due to developmental changes in the ventral segmental arteries. Multidetector computed tomography (MDCT) has been used to investigate vascular anatomy for scientific and diagnostic purposes. These studies allow for much larger sample sizes than traditional cadaveric studies. The aim of this research was to isolate rare anatomical variants of the coeliac trunk and emphasize their clinical significance.

Materials and methods: A descriptive, retrospective study was carried out on MDCT angiographies performed from January 2020 till March 2020 in Polish patients. Coeliac trunk was studied and normal and anatomical variations were identified.

Results: Out of total 350 patients, hepatogastrosplenic trunk was predominant. However, we observed: coeliaco-mesenteric and hepatogastric trunk type, hepatic artery variations and coeliac axis stenosis with collateral mesenteric circulation.

Conclusions: Rare variations of the coeliac trunk should always be anticipated before radiological and surgical interventions. Knowledge of unusual coeliac trunk anatomy is important in hepatopancreatobiliary surgery, transplantology, and interventional radiology.

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Keywords

coeliac trunk, variations, multidetector computed tomography angiography

About this article
Title

Unusual variations in the branching pattern of the coeliac trunk and their clinical significance

Journal

Folia Morphologica

Issue

Vol 80, No 2 (2021)

Article type

Original article

Pages

283-289

Published online

2020-06-09

Page views

1501

Article views/downloads

1421

DOI

10.5603/FM.a2020.0067

Pubmed

32639575

Bibliographic record

Folia Morphol 2021;80(2):283-289.

Keywords

coeliac trunk
variations
multidetector computed tomography angiography

Authors

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

References (52)
  1. Ailawadi G, Cowles RA, Stanley JC, et al. Common celiacomesenteric trunk: aneurysmal and occlusive disease. J Vasc Surg. 2004; 40(5): 1040–1043.
    CrossRefPubMed
  2. Alakkam A, Hill RV, Saggio G. Superior mesenteric origin of the proper hepatic artery: embryological and clinical implications. Surg Radiol Anat. 2016; 38(6): 747–750.
    CrossRefPubMed
  3. Aschenbach R, Basche S, Vogl TJ. Compression of the celiac trunk caused by median arcuate ligament in children and adolescent subjects: evaluation with contrast-enhanced MR angiography and comparison with Doppler US evaluation. J Vasc Interv Radiol. 2011; 22(4): 556–561.
    CrossRefPubMed
  4. Ayers NP, Zacharias SJ, Abu-Fadel MS, et al. Successful use of blunt microdissection catheter in a chronic total occlusion of a celiomesenteric artery. Catheter Cardiovasc Interv. 2007; 69(4): 546–549.
    CrossRefPubMed
  5. Berard X, Cau J, Déglise S, et al. Laparoscopic surgery for coeliac artery compression syndrome: current management and technical aspects. Eur J Vasc Endovasc Surg. 2012; 43(1): 38–42.
    CrossRefPubMed
  6. Cavdar S, Sehirli U, Pekin B. Celiacomesenteric trunk. Clin Anat. 1997; 10(4): 231–234, doi: 10.1002/(SICI)1098-2353(1997)10:4<231::AID-CA2>3.0.CO;2-V.
    PubMed
  7. 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.
    CrossRefPubMed
  8. Daly J. Long-term hepatic arterial infusion chemotherapy. Arch Surg. 1984; 119(8): 936.
    CrossRef
  9. Detroux M, Anidjar S, Nottin R. Aneurysm of a common celiomesenteric trunk. Ann Vasc Surg. 1998; 12(1): 78–82.
    CrossRefPubMed
  10. Ferrari R, De Cecco CN, Iafrate F, et al. Anatomical variations of the coeliac trunk and the mesenteric arteries evaluated with 64-row CT angiography. Radiol Med. 2007; 112(7): 988–998.
    CrossRefPubMed
  11. Friesen SR. The significance of the anomalous origin of the left hepatic artery from the left gastric artery in operations upon the stomach and esophagus. Am Surg. 1957; 23(12): 1103–1108.
    PubMed
  12. Gielecki J, Zurada A, Sonpal N, et al. The clinical relevance of coeliac trunk variations. Folia Morphol. 2005; 64(3): 123–129.
    PubMed
  13. Grotemeyer D, Duran M, Iskandar F, et al. Median arcuate ligament syndrome: vascular surgical therapy and follow-up of 18 patients. Langenbecks Arch Surg. 2009; 394(6): 1085–1092.
    CrossRefPubMed
  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.
    PubMed
  15. Hemming AW, Finley RJ, Evans KG, et al. Esophagogastrectomy and the variant left hepatic artery. Ann Thorac Surg. 1992; 54(1): 166–168.
    CrossRefPubMed
  16. Hiatt JR, Gabbay J, Busuttil RW. Surgical anatomy of the hepatic arteries in 1000 cases. Ann Surg. 1994; 220(1): 50–52.
    CrossRefPubMed
  17. Huang CM, Chen QY, Lin JX, et al. Short-term clinical implications of the accessory left hepatic artery in patients undergoing radical gastrectomy for gastric cancer. PLoS One. 2013; 8(5): e64300.
    CrossRefPubMed
  18. Iezzi R, Cotroneo AR, Giancristofaro D, et al. Multidetector-row CT angiographic imaging of the celiac trunk: anatomy and normal variants. Surg Radiol Anat. 2008; 30(4): 303–310.
    CrossRefPubMed
  19. Jimenez JC, Harlander-Locke M, Dutson EP. Open and laparoscopic treatment of median arcuate ligament syndrome. J Vasc Surg. 2012; 56(3): 869–873.
    CrossRefPubMed
  20. Juszczak A, Czyżowski J, Mazurek A, et al. Anatomical variants of celiac trunk in Polish population using multidetector computed tomography angiography. Folia Morphol. 2020 [Epub ahead of print].
    CrossRefPubMed
  21. Juszczak A, Mazurek A, Walocha JA, et al. Coeliac trunk and its anatomic variations: a cadaveric study. Folia Morphol. 2021; 80(1): 114–121.
    CrossRefPubMed
  22. 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.
    PubMed
  23. Kahn CI, MacNeil M, Fanola C, et al. Complex arterial patterning in an anatomical donor. Trans Res Anat. ; 2018(12): 11–19.
  24. Kalra M, Panneton JM, Hofer JM, et al. Aneurysm and stenosis of the celiomesenteric trunk: a rare anomaly. J Vasc Surg. 2003; 37(3): 679–682.
    CrossRefPubMed
  25. Katagiri H, Ichimura K, Sakai TA. case of celiacomesenteric trunk with some other arterial anomalies in a Japanese woman. Anat Sci Int. 2007; 82: 53–58.
  26. Kim EN, Lamb K, Relles D, et al. Median arcuate ligament syndrome-review of this rare disease. JAMA Surg. 2016; 151(5): 471–477.
    CrossRefPubMed
  27. Lagoutte N, Facy O, Guiu B, et al. Celiacomesenteric trunk: a variation that must be known before aortic surgery. Clin Pract. 2011; 1(3): e69.
    CrossRefPubMed
  28. Lanz VT, Wachsmuth W. Lanz/Wachsmuth Practical Anatomy. Springer-Verlag, Berlin 2003.
  29. Lee JK, Kang SR, Kim J, et al. A rare variation of the incomplete coeliac trunk. Folia Morphol. 2016; 75(1): 122–124.
    CrossRefPubMed
  30. Lovisetto F, Finocchiaro De Lorenzi G, Stancampiano P, et al. Thrombosis of celiacomesenteric trunk: report of a case. World J Gastroenterol. 2012; 18(29): 3917–3920.
    CrossRefPubMed
  31. Lurie AS. The significance of the variant left accessory hepatic artery in surgery for proximal gastric cancer. Arch Surg. 1987; 122: 725–728.
  32. Michels NA. Newer anatomy of the liver and its variant blood supply and collateral circulation. Am J Surg. 1966; 112(3): 337–347.
    CrossRefPubMed
  33. Nantiskarn C, Kiat A. Aberrant branches of the superior mesenteric artery detected by MDCT angiography of abdominal aorta. Asian Biomedicine. 2012; 6(2): 219–226.
  34. Nebesar RA, Kornblith PL, Pollard JJ, Michels NA. Celiac and superior mesenteric arteries: a correlation of angiograms with dissections. Little, Brown, Boston 1969.
  35. Olewnik Ł, Wysiadecki G, Polguj M, et al. Types of coeliac trunk branching including accessory hepatic arteries: a new point of view based on cadaveric study. Folia Morphol. 2017; 76(4): 660–667.
    CrossRefPubMed
  36. Oran I, Yesildag A, Memis A. Aortic origin of right hepatic artery and superior mesenteric origin of splenic artery: two rare variations demonstrated angiographically. Surg Radiol Anat. 2001; 23(5): 349–352.
    CrossRefPubMed
  37. Ratra A, Campbell S. Recurrent mesenteric ischemia from celiomesenteric trunk stenosis. Cureus. 2018; 10(6): e2751.
    CrossRefPubMed
  38. Rosenblum JD, Boyle CM, Schwartz LB. The mesenteric circulation. Anatomy and physiology. Surg Clin North Am. 1997; 77(2): 289–306.
    CrossRefPubMed
  39. 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.
    CrossRefPubMed
  40. Shinohara T, Ohyama S, Muto T, et al. The significance of the aberrant left hepatic artery arising from the left gastric artery at curative gastrectomy for gastric cancer. Eur J Surg Oncol. 2007; 33(8): 967–971.
    CrossRefPubMed
  41. Suzuki T, Nakayasu A, Kawabe K, et al. Surgical significance of anatomic variations of the hepatic artery. Am J Surg. 1971; 122(4): 505–512.
    CrossRefPubMed
  42. Tandler J. über die Varietäten der Arteria coeliaca und deren Entwickelung. Beiträge und Referate zur Anatomie und Entwickelungsgeschichte. Anat Embryol. 1904; 25(2): 473–500.
    CrossRef
  43. Tang W, Shi J, Kuang LQ, et al. Celiomesenteric trunk: New classification based on multidetector computed tomography angiographic findings and probable embryological mechanisms. World J Clin Cases. 2019; 7(23): 3980–3989.
    CrossRefPubMed
  44. Tasleem SH, Younas F, Syed FA, et al. Endovascular repair of common celiomesenteric trunk stenosis. Vasa. 2010; 39(4): 341–343.
    CrossRefPubMed
  45. van Petersen AS, Kolkman JJ, Gerrits DG, et al. Dutch Mesenteric Ischemia Study Group. Clinical significance of mesenteric arterial collateral circulation in patients with celiac artery compression syndrome. J Vasc Surg. 2017; 65(5): 1366–1374.
    CrossRefPubMed
  46. van Petersen AS, Vriens BH, Huisman AdB, et al. Retroperitoneal endoscopic release in the management of celiac artery compression syndrome. J Vasc Surg. 2009; 50(1): 140–147.
    CrossRefPubMed
  47. Walker TG. Mesenteric vasculature and collateral pathways. Semin Intervent Radiol. 2009; 26(3): 167–174.
    CrossRefPubMed
  48. Wang Yi, Chen P, Shen N, et al. Celiomesenteric trunk with concurrent aneurysm: report of a case. Surg Today. 2010; 40(5): 477–481.
    CrossRefPubMed
  49. 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.
    CrossRefPubMed
  50. 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.
    CrossRefPubMed
  51. Winston CB, Lee NA, Jarnagin WR, et al. CT angiography for delineation of celiac and superior mesenteric artery variants in patients undergoing hepatobiliary and pancreatic surgery. Am J Roentgenol. 2007; 189(1): W13–W19.
    CrossRefPubMed
  52. 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.
    CrossRefPubMed

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