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Hexafurcated coeliac trunks, trifurcated common hepatic artery, and a new variant of the arc of Bühler
Affiliations- Division of Anatomy, Department 1, 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, Timişoara, Romania
- Department of Functional Sciences, Discipline of Public Health, Faculty of Medicine, “Victor Babeş” University of Medicine and Pharmacy, Timisoara, Romania
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Abstract
Background: The coeliac trunk (CT) is well-known as trifurcated into the left gastric (LGA), common hepatic (CHA) and splenic (SA) arteries.
Materials and methods: Scarce reports indicate that the CT could appear quadri-, penta-, hexa-, or even heptafurcated. Reports of CTs with six branches (hexafurcated CT) are few, less than ten. The hexafurcated CT variant was documented by a retrospective study of 93 computed tomography angiograms.
Results: Two hexafurcated CTs were found. In one case an arc of Bühler was added to the inferior phrenic arteries, LGA, CHA and SA. In the second case the dorsal pancreatic artery was added to the other five branches. That arc of Bühler descended in front of the aorta to connect with the origin of the third jejunal artery. The CHA in that second case was trifurcated into the left and right hepatic arteries, and the gastroduodenal artery; the proper hepatic artery was absent.
Conclusions: Although the hexafurcated CT, as well as the trifurcated CHA, are rarely occurring and reported anatomic variants, this doesn’t mean they could not be encountered during surgical or interventional procedures, which they would complicate if not recognised. Moreover, the arc of Bühler, the embryonic remnant, was not reported previously to insert into the CT as an additional branch of it.
Abstract
Background: The coeliac trunk (CT) is well-known as trifurcated into the left gastric (LGA), common hepatic (CHA) and splenic (SA) arteries.
Materials and methods: Scarce reports indicate that the CT could appear quadri-, penta-, hexa-, or even heptafurcated. Reports of CTs with six branches (hexafurcated CT) are few, less than ten. The hexafurcated CT variant was documented by a retrospective study of 93 computed tomography angiograms.
Results: Two hexafurcated CTs were found. In one case an arc of Bühler was added to the inferior phrenic arteries, LGA, CHA and SA. In the second case the dorsal pancreatic artery was added to the other five branches. That arc of Bühler descended in front of the aorta to connect with the origin of the third jejunal artery. The CHA in that second case was trifurcated into the left and right hepatic arteries, and the gastroduodenal artery; the proper hepatic artery was absent.
Conclusions: Although the hexafurcated CT, as well as the trifurcated CHA, are rarely occurring and reported anatomic variants, this doesn’t mean they could not be encountered during surgical or interventional procedures, which they would complicate if not recognised. Moreover, the arc of Bühler, the embryonic remnant, was not reported previously to insert into the CT as an additional branch of it.
Keywords
aorta, computed tomography, hepatic artery, splenic artery, superior mesenteric artery, arc of Bühler, portal vein
About this articleTitle
Hexafurcated coeliac trunks, trifurcated common hepatic artery, and a new variant of the arc of Bühler
Journal
Issue
Article type
Original article
Pages
365-371
Published online
2021-03-01
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5514
Article views/downloads
1533
DOI
Pubmed
Bibliographic record
Folia Morphol 2022;81(2):365-371.
Keywords
aorta
computed tomography
hepatic artery
splenic artery
superior mesenteric artery
arc of Bühler
portal vein
Authors
B. A. Manta
M. C. Rusu
A. M. Jianu
A. C. Ilie
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