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Hepatomesenteric trunk, gastrosplenic trunk, coiled splenic and hepatic arteries, and a variant of Bühler’s arc
, 4, 5
Affiliations- Department of Surgery, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Timişoara, Romania
- Division of Anatomy, Faculty of Dental Medicine, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
- Department of Anatomy and Embryology, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Department of Radiology and Medical Imaging, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- ”Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
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Abstract
The coeliac trunk is normally divided into the left gastric artery (LGA), splenic artery, 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-year-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 and gastroduodenal arteries. The proper hepatic artery 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 coeliac region are accurately distinguished on computed tomography angiograms. They should be evaluated by surgeons when different surgical procedures are evaluated.
Abstract
The coeliac trunk is normally divided into the left gastric artery (LGA), splenic artery, 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-year-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 and gastroduodenal arteries. The proper hepatic artery 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 coeliac region are accurately distinguished on computed tomography angiograms. They should be evaluated by surgeons when different surgical procedures are evaluated.
Keywords
aorta, coeliac trunk, superior mesenteric artery, computed tomography, hepatic artery
About this articleTitle
Hepatomesenteric trunk, gastrosplenic trunk, coiled splenic and hepatic arteries, and a variant of Bühler’s arc
Journal
Issue
Article type
Case report
Pages
1032-1036
Published online
2020-11-03
Page views
6628
Article views/downloads
960
DOI
Pubmed
Bibliographic record
Folia Morphol 2021;80(4):1032-1036.
Keywords
aorta
coeliac 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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