Frontiers Journal of Anatomical Variations (FJAV)

Branching Pattern Variations Of The Celiac Trunk And Superior Mesenteric Arteries In A 94-Year-Old White Female Cadaver

Keywords : Celiac Trunk Variations, Cystic Artery Variations, Superior Mesenteric Variations, Arterial Branching Variations, Replaced Or Aberrant Left Colic Artery, Inferior Phrenic Artery Variations, Accessory Left Hepatic Artery, Accessory Left Gastric Artery, Accessory Aberrant Left Colic Artery, Anatomical Variations, Gastrointestinal Anatomical Variations

Abstract

Recognizing the presence of abdominal vascular anatomical variations in patients is imperative for surgeons who perform major abdominal surgeries, vascular interventionalists performing ablations or embolizations, and oncologists administering targeted chemotherapies. Neglecting to identify such variations can lead to significant patient morbidity and mortality. It is similarly important to anatomical instructors in the education of future medical providers. During cadaveric dissection of fifty-six cadavers, we observed several unique anatomical variations occurring within the major enteric vessels of the abdomen of a 94-year-old white female cadaver. These variations included a celiac trunk that gave rise to bilateral inferior phrenic arteries, the splenic artery, and a gastrohepatic artery that gave off the left gastric artery, an accessory left hepatic artery, and then continued as a common hepatic artery. Shortly from its origin, the common hepatic artery then trifurcated into a large gastroduodenal artery, the right hepatic artery, and the left hepatic artery. There was no definitive proper hepatic artery present. The accessory left hepatic artery gave off an accessory left gastric artery. The cystic artery derived directly from the superior mesenteric artery, and the middle colic artery arose from the gastroduodenal artery. The middle colic artery also had an accessory aberrant left colic artery branching from it. These anatomical variations described herein are of both clinical significance and academic consequence. While single anatomic variations are well described, the presence of multiple, complex variations in a single patient, such as those described here, is less common in the literature. To our knowledge, there are no other reports of this combination of variations in the literature to date. Operating surgeons and vascular interventionalists should be aware of these variants as they occur both individually and in combination while treating diverse patient populations. Accordingly, the developmental and clinical significance of these anomalous vessels is discussed here.

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