Anat Cell Biol.  2015 Jun;48(2):147-150. 10.5115/acb.2015.48.2.147.

Multiple variations in the branches of the coeliac trunk

• Sumalatha
• Hosapatna
• Bhat KR
• D'souza AS
• Kiruba L
• Kotian SR

• KMID: 1845284
• DOI: http://doi.org/10.5115/acb.2015.48.2.147

Abstract

Here we present a unique case of variation in the branching pattern of the coeliac trunk. In the present case, the coeliac trunk was replaced by two separate arterial trunks. The first arterial trunk bifurcated into the left gastric and the left hepatic arteries. The second arterial trunk bifurcated into a splenic artery and a hepato-gastroduodenal trunk. The hepato-gastroduodenal trunk presented an unusual course and termination. The right hepatic artery arising from the hepato-gastroduodenal trunk also showed a variant course. Such rare variations are important for gastroenterological surgeons and interventional radiologists due to increase in number of transplantation surgeries and live donor liver transplantations.

Keyword

Coeliac trunk; Left gastric artery; Hepato-gastroduodenal trunk; Right hepatic artery; Portal vein

MeSH Terms

Hepatic Artery
Humans
Liver Transplantation
Portal Vein
Splenic Artery
Tissue Donors

Figure

• 

  Fig. 1 Showing two separate arterial trunks (CT1 and CT2) at the level of lower border of T12 vertebra arising from the abdominal aorta (AA). A well-defined coeliac trunk was absent. The first arterial trunk (CT1), after arising from the abdominal aorta further bifurcated and provided the left gastric (LGA) and the left hepatic arteries (LHA). The second arterial trunk (CT2), about 1.5 cm long further bifurcated into a splenic artery (SA) and a hepato-gastroduodenal trunk (HGT). The HGT presented an unusual course as it moved to the right, further passing deep to the portal vein (PV). RHA, right hepatic artery; SPDA, superior pancreatico-duodenal artery; SV, splenic vein.

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  Fig. 2 Showing the hepato-gastroduodenal trunk (HGT) emerging anteriorly at the lower border of the neck of the pancreas. It then bifurcated into right hepatic (RHA) and superior pancreatico-duodenal arteries (SPDAs). The right hepatic artery further ascended, passing anterior to the neck of the pancreas to reach the porta-hepatis to supply the right lobe of the liver. The cystic branch (CA) was also provided by the right hepatic artery. The SPDA when traced passed anterior to the head of the pancreas to reach the pancreatico-duodenal groove. GB, gallbladder; SMA, superior mesentric artery; SMV, superior mesentric vein.

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  Fig. 3 Schematic representation of the variations in the branching pattern of the coeliac trunk. AA, abdominal aorta; CA, cystic artery; CT 1& 2, common trunks 1&2; HGT, hepatogastroduodenal trunk; LGA, left gastric artery; LHA, left hepatic artery; SA, splenic artery; SPDA, superior pancreatico-duodenal artery; SV, splenic vein; RGEA, right gastro-epiploeic artery; RHA, right hepatic artery; PV, portal vein.

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