Clinical significance of variant anatomy of the celiac trunk

Abstract

Data on variant anatomy of the celiac trunk, typical and atypical variants of its architectonics, topography, existing classifications, morphometric characteristics, development of the vessels of abdominal aorta in embryogenesis and the clinical significance of anatomical features is presented. The issues under consideration are important for surgical practice, in particular, for abdominal surgery, transplantology, interventional X-ray endovascular surgery and oncosurgery. It is shown that the anatomy of the celiac trunk and its branches have a pronounced variability, and more than 15% of the population have significant deviations from the typical branching variant. A significant number of different variants of the celiac trunk dividing, a different frequency of occurrence of these variants, morphometric indices, apparently depends on the size of the sample of the investigated objects, gender and other reasons. Data on the development of branches of the abdominal aorta in embryogenesis and the causes of atypical variants is presented. In a comparative aspect, existing classifications of the most authoritative authors are considered. It is shown that, despite the large number, there is no universal, simplest in practice, classification of variants of the celiac trunk branching. Nosological examples that demonstrate the need to take into account the variant of formation of the celiac trunk and its morphometric features in operative and diagnostic manipulations on the organs and vessels of the upper floor of the peritoneal cavity are analyzed. Certainly without understanding the architectonics of the gastrosplenicpancreatoduodenal zone arteries, there is a significant risk of error, which can even lead to lethal complications.

Keywords

celiac trunk / variant anatomy / splenic artery / left gastric artery / common hepatic artery / superior mesenteric artery / architectonics / topography / typical variant / atypical variants

References

[1] Гайворонский, И.В. Морфометрические характеристики свя- зок селезёнки и их топографо-анатомические отношения с ветвями селезеночной артерии и хвостом поджелудочной железы / И.В. Гайворонский [и др.] // Человек и его здоровье: научно-практический вестник (Курск). - 2015. - №2. - С. 66-73.

[2] Adachi, B. Das Arteriensystem der Japaner. Vol. 2 / B. Adachi. - Kyoto: Kaiserlich-Japanischen Universitaüt, 1928. - 353 p.

[3] Babu, D.E. Coeliac trunk variations: Review with proposed new classifications / D.E. Babu, P. Khrab // Int. J. Anat. Res. - 2013. - Vol. 1, № 3. - P. 165-170.

[4] Cicekcibasi, A. A rare variation of the coeliac trunk / A. Cicekcibasi [et al.] // Ann. Anat. - 2005. - Vol. 187. - P. 387-391.

[5] Ennubli, E. Etuds. Embryonaire des arteries intercostales. Reconstructionpal la method be Born deux embryons humains et 17mm / E. Ennubli, M. Niveiro // Parthol. Biol. - 1967. - Vol. 15. - P. 92-98.

[6] Gielecki, J. The clinical relevance of coeliac trunk variations / J. Gielecki, A. Zurada, N. Sonpal, B. Jabüoüska // Folia Morphol. (Warsz). - 2005. - Vol. 64, № 3. - P. 123-129.

[7] Gokan, T. Helical CT demonstration of dilated right inferior phrenic arteries as extrahepatic collateral arteries of hepatocellular carcinomas / T. Gokan [et al.] // J. Comput. Assist. Tomogr. -2001. - Vol. 25, № 1. - P. 68-73.

[8] Lipschutz, B. A composite study of the coeliac artery / B. Lipschutz // Ann. Surg. -1917. - Vol. 65. - P. 159-169.

[9] Malnar, D. Anatomical properties of the celiac trunk / D. Malnar [et al.] // Coll. Antropol. - 2010. - Vol. 34, № 3. - P. 917-921.

[10] Michels, N.A. The hepatic, cystic and retro duodenal arteries and their relations to the biliary duct / N.A. Michels // Ann. Surg. - 1951. - Vol. 133. - P. 503-524.

[11] Nayak, S.R. Additional branches of celiac trunk and its clinical significance / S.R. Nayak [et al.] // Romanian Journal of Morphology and Embryology. - 2008. - Vol. 49, № 2. - P. 247-249.

[12] Petrella, S. Origin of inferior phrenic arteries in the celiac trunk / S. Petrella [et al.] // Int. J. Morphol. - 2006. - Vol. 24, № 2. - P. 275-278.

[13] Pushpalatha, K. A study of anatomical variations in the origin, length and branches of celiac trunk and its surgical significance / K. Pushpalatha, B. Deepa, S.N.M. Shama // Int. J. Anat. Res. - 2016. - Vol. 4, № 1. - P. 1781-1788.

[14] Saritha, S. Cadaveric study of accessory renal arteries and its surgical correlation / S. Saritha, N. Jyothi, M. Kumar, G. Supriya // International Journal of Research in Medical Sciences. - 2017. - Vol. 1, № 1. - P. 19-22.

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

[16] Silveira, L.A. Arterial diameter of the celiac trunk and its branches: anatomical study / L.A. Silveira, F.B.C. Silveira, V.P.S. Fazan // Acta Cir. Bras. - 2009. - Vol. 24, № 1. - P. 43-47.

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

[18] Standring S. Gray’s Anatomy, anatomical basis of clinical practice / S. Standring. - New York, London, Philadelphia: Churchill Livingstone, 2008. - 1576 p.

[19] Suman, T. Study of origin of inferior phrenic arteries from the coeliac trunk / T. Suman, K. Jeyanthi // Anatomica Karnataka. - 2012. - Vol. 6, № 3. - P. 38-41.

[20] Sürücü, H.S. Anatomy of the celiac trunk examined by CT imaging of 104 individuals / H.S. Sürücü [et al.] // Morphologie. - 2003. - Vol. 87, № 277. - P. 33-35.

[21] Tandler, J. Uber die Varietaten der Arteria coeliaca und deren Entwicklung / J. Tandler // Anat Hft. - 1904. - Vol. 25. - P. 472-500.

[22] Tihan, D. Absence of the celiac trunk in a rectal cancer patient: case report / D. Tihan [et al.] // Anatomy. - 2016. - Vol. 10, № 3. - P. 235-238.

[23] Tiwari, S. Study of origin of inferior phrenic arteries from the celiac trunk / S. Tiwari, K. Jeyanthi // Anatomica Karnataka. - 2012. - Vol. 6, № 3. - P. 38-41.

[24] Uflacker, R. Atlas of vascular anatomy: an angiographic approach / R. Uflacker. - Baltimore: Williams & Wilkins, 1997. - 811 p.

[25] Venieratos, D. A morphometric study of the celiac trunk and review of the literature / D. Venieratos [et al.] // Clin. Anat. - 2013. - Vol. 26. - P. 741-750.

RIGHTS & PERMISSIONS

Gaivoronsky I.V., Kotiv B.N., Kovalenko N.A., Pelipas Y.V., Bahovadinova S.B., Amelina I.D., Kudryavtseva A.V., Dzidzava I.I., Verbitsky V.V.