Anat Cell Biol.  2018 Sep;51(3):143-149. 10.5115/acb.2018.51.3.143.

Variations in the branching pattern of the celiac trunk and its clinical significance

• Hemamalini

• KMID: 2447006
• DOI: http://doi.org/10.5115/acb.2018.51.3.143

Abstract

Celiac trunk is the artery of foregut, arising from the abdominal aorta at the level of T12/L1 vertebral body. It extends approximately 1.5 to 2 cm horizontally forwards before dividing into three branches: left gastric, common hepatic, and splenic arteries. Out of the three ventral branches of abdominal aorta, celiac trunk is more prone to have variations. During routine dissection of abdomen for undergraduate students we found some rare variations in the branching pattern of the celiac trunk. Absence of celiac trunk with hepatomesenteric trunk, quadrifurcation with dorsal pancreatic artery arising from it, quadrifurcation with middle colic artery arising from it, left inferior phrenic artery arising from celiac trunk, highly tortuous splenic artery supplying distal 1/3rd of transverse colon and hepatosplenic trunk. Knowledge of such variations is essential for liver and pancreas transplantations, pancreaticoduodenectomy, radiological abdominal interventions, laproscopic surgeries, and in trauma of the abdomen.

Keyword

Celiac trunk; Common hepatic artery; Hepatomesenteric trunk; Dorsal pancreatic artery; Middle colic artery

MeSH Terms

Abdomen
Aorta, Abdominal
Arteries
Colic
Colon, Transverse
Humans
Liver
Pancreas Transplantation
Pancreaticoduodenectomy
Splenic Artery

Figure

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  Fig. 1 Absence of celiac trunk with an hepatomesenteric trunk. AA, abdominal aorta; CHA, common hepatic artery; DPA, dorsal pancreatic artery; GDA, gastroduodenal artery; HMT, hepatomesenteric trunk; IPDA, inferior pancreaticoduodenal artery; LGA, left gastric artery; LHA, left hepatic artery; LIPA, left inferior phrenic artery; PHA, proper hepatic artery; RGA, right gastric artery; RGEA, right gastroepiploic artery; RHA, right hepatic artery; RIPA, right inferior phrenic artery; SA, splenic artery; SMA, superior mesenteric artery; SMV, superior mesenteric vein; SPDA, superior pancreatic duodenal artery.

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  Fig. 2 Quadrifurcation of celiac trunk showing origin of dorsal pancreatic artery from the celiac trunk. CHA, common hepatic artery; DPA, dorsal pancreatic artery; LGA, left gastric artery; SA, splenic artery.

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  Fig. 3 (A) Quadrifurcation of celiac trunk showing origin of middle colic artery (MCA) from the celiac trunk. (B) MCA showing trifurcation in the transverse mesocolon. (C) Left branch of middle colic anastomosing with the sigmoidal artery. Note the absence of left colic artery from inferior mesenteric artery (IMA). CHA, common hepatic artery; LB, left branch; LGA, left gastric artery; MB, middle branch; RB, right branch; SA, sigmoidal artery.

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  Fig. 4 Celiac trunk giving origin to left inferior phrenic artery (LIPA) and hepatosplenic trunk (HST). LGA, left gastric artery.

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  Fig. 5 Tortuous splenic artery (SA) giving branch to splenic flexure of colon. CHA, common hepatic artery; LGA, left gastric artery.

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  Fig. 6 Schematic representation of the absence of coeliac trunk with an hepatomesenteric trunk (HMT). CHA, common hepatic artery; DPA, dorsal pancreatic artery; GDA, gastroduodenal artery; IPDA, inferior pancreaticoduodenal artery; LGA, left gastric artery; LIPA, left inferior phrenic artery; PHA, proper hepatic artery; RGEA, right gastroepiploic artery; RIPA, right inferior phrenic artery; SA, splenic artery; SMA, superior mesenteric artery; SMV, superior mesenteric vein; SPDA, superior pancreatic duodenal artery.

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  Fig. 7 Schematic representation of the quadrifurcation of coeliac trunk with middle colic artery. LGA, left gastric artery; CHA, common hepatic artery; SA, sigmoidal artery; MCA, middle colic artery; RB, right branch; LB, left branch; MB, middle branch; RCA, right colic artery; SMA, superior mesenteric artery; ICA, ileocolic artery; IMA, inferior mesenteric artery.

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