VARIANT ANATOMY OF THE CELIAC TRUNK, ITS MAIN AND ABERRANT BRANCHES

Abstract

Objective - with the use of postvital and intravital methods of investigation, to study the patterns of branching and morphometric characteristics of the celiac trunk, its main branches and aberrant arteries, the most significant atypical variants and frequency of their occurrence. Material and methods. The results of multi-phase spiral computed tomography angiography of 100 patients, digital subtraction angiography of 100 patients were retrospectively analyzed, cadaveric material of adults (76 objects), 16 corrosion preparations were studied, a total of 292 observations. The level of deviation of the celiac trunk from the abdominal part of the aorta, the morphometric characteristics of the celiac trunk and its branches, the branching pattern and frequency of typical and atypical variants of branching of the celiac trunk and its main branches, their aberrant arteries were estimated. Results. In most cases, the celiac trunk arose at the level of the intervertebral discs TXII-LI (76 %), with a range from TXII to LII. The length and diameter of the celiac trunk and its branches were characterized by a wide range of differences between the minimum and maximum values. In 83 % of the observations, the celiac trunk had a typical pattern of trifurcation, atypical variants were represented by bifurcation (14.7 %), quadrifurcation (1.3 %), pentafurcation (0.3 %), absence of trunk (0.3 %), as well as various variants of branching with the presence of aberrant arteries (9 %). Multiphase spiral computed tomography angiography and digital subtraction angiography demonstrated high intravital efficiency in displaying various branching patterns of the celiac trunk and its branches. The knowledge of anatomical variants helps to plan the operation at the preoperative stage, and can reduce the incidence of complications and risk of iatrogenic lesions during surgical intervention. Conclusions. The celiac trunk and its branches have a wide range of variant anatomy concerning its topography, branching pattern and the presence of aberrant arteries.

Keywords

celiac trunk / variant anatomy / left gastric artery / common hepatic artery / aberrant arteries

References

[1] Гайворонский И. В., Лазаренко В. А., Котив Б.Н и др. Морфометрические характеристики связок селезенки и их топографоанатомические отношения с ветвями селезеночной артерии и хвостом поджелудочной железы // Курский научно-практический вестник «Человек и его здоровье». 2015. № 2. С. 66-73.

[2] Семиошко Н. В. Вариантная анатомия ветвления чревного ствола и прилежащих к нему лимфатических узлов // Педиатрический вестник Южного Урала. 2015. № 1. С. 37-42.

[3] Adachi B. Das Arteriensystem der Japaner. Verlag der Kaiserlich-Japanischen Universitatzu Kyoto. 1928. Vol. 2. P. 18-71.

[4] Ennubli E., Niveiro M. Etuds. Embryonaire des arteries intercostales. Reconstructionpal la method be Born deux embryons humains 14 et 17 mm // Parthol. Biol. 1967. № 15. P. 92-98.

[5] Lipshutz B. B. A composite study of the celiac axis artery // Ann. Surg. 1917. Vol. 65, № 2. P. 159-169.

[6] Michels N. A. Newer anatomy of the liver and its variant blood supply and collateral circulation // Am. J. Surg. 1966. Vol. 112, № 3. P. 337-347.

[7] Nayak S. R., Prabhu L. V., Krishnamurthy A. et al. Additional branches of celiac trunk and its clinical significance // Romanian J. of Morphology and Embryology. 2008. Vol. 49, № 2. P. 247-249.

[8] Osman A. M., Abdrabou A. Celiac trunk and hepatic artery variants: a retrospective preliminary MSCT report among Egyptian patients // The Egyptian Journal of Radiology and Nuclear Medicine. 2016. Vol. 47. P. 1451-1458.

[9] Piano D., Ohtsuka A., Murakami T. Typology of abdominal arteries, with special references to inferior phrenic arteries and their esophageal branches // Acta Medica Okayama. 1988. Vol. 52, № 4. P. 189-196.

[10] Saeed M., Murshid K. R., Rufai A. A. et al. Coexistence of multiple anomalies in the celiac-mesenteric arterial system // Clin. Anat. 2003. Vol. 16, № 1. P. 30-36.

[11] Selvaraj L., Sundaramurthi I. Study of normal branching pattern of the coeliac trunk and its variations using CT angiography // J. Clin. Diagn. Res. 2015. Vol. 9, № 9. P. 1-4.

[12] Song S. Y., Chung J. W., Yin Y. H. et al. Celiac axis and common hepatic artery variations in 5002 patients: systematic analysis with spiral CT and DSA // Radiology. 2010. Vol. 255, № 1. P. 278-288.

[13] Uflacker R. Atlas of vascular anatomy: an angiographic approach. Baltimore: Williams & Wilkins citied in the British Journal of Anatomy, 2010. Vol. 83. P. 661-667.

[14] Wadhwa A., Soni S. A composite study on the coeliac trunk in 30 adult human cadavers - its clinical implications // Global J. Med. Res. 2011. Vol. 11, № 1. P. 35-38.

[15] Yi S. Q., Terayama H., Naito M. et al. Absence of the celiac trunk: case report and review of the literature // Clin. Anat. 2008. Vol. 21. P. 283-286.

RIGHTS & PERMISSIONS

Eco-Vector