The authors report a case of a 44-year-old male found to have unusual origins of the celiac trunk (CT) and superior mesernteric artrery (SMA) as revealed by routine multidetector computed tomograph (MDCT) angiography. The CT and SMA originate from the thoracic aorta (TA) 21 mm and 9 mm above the aortic hiatus, respectively. The median arcuate ligament (MAL) is located at the level of the L1-L2 intervertebral disc. The course of the CT descends in the thoracic cavity making a 14° acute downward angle in front of the TA; below the level of the MAL, the CT descends, making an angle of 47°. The course of the SMA descends at both the thoracic and abdominal level making an angle of 17°, and having an aortomesenteric distance of 9 mm at the level of the third part of the duodenum. In the present case, the supradiaphragmatic origin of the CT and the SMA was determined by their incomplete caudal descent, associated with a pronounced apparent descent of the diaphragm. A thoracic origin of the CT and SMA and the acute downward aortomesenteric angle (17°) associated with a reduced aortomesenteric distance at the level of the third part of the duodenum (9 mm), although no clinical signs are present, may predispose the patient to develop simultaneously a triple syndrome: the compression of CT by MAL (celiac axis compression syndrome), the compression of SMA by MAL (superior mesenteric artery compression syndrome), and the compression of the duodenum by the SMA (superior mesenteric artery syndrome).

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The group of small hepatic veins form the lower group of hepatic veins ‐ participating in the venous drainage (VD) of the caudate lobe (CL) ‐ and the lower portions of right and left hepatic lobes. VDCL was examined by a number of 150 hepatic corrosion casts; the pieces were made by injecting plastic mass in the vascularductal elements of the liver, followed by corrosion of the parenchyma with hydrochloric acid. The number of the CL veins varies from four to fifteen (average of 8.77 veins/piece). The analysis of VDCL depending collector hepatic veins (HV) demonstrates that: the left HV participates in VDCL 17.33% by the tail vein 1.3 (mean 1.80 veins/piece); the middle HV participates in VDCL 100% through the tail vein 4.8 (mean 5.2 veins/piece); the common trunk formed from the middle and left HV participates in the VDCL as a percentage of 11.11%; the right superior HV participates in VDCL as a percentage of 62.67% through the tail vein 2.4 (mean 2.75 veins/piece); the right inferior HV participates in VDCL as a percentage of 12% CL by the tail vein 1.3 (mean 2.22 veins/piece); the Inferior Vena Cava (IVC) venous drainage involved in the CL in 100% of cases, 1.4 veins (veins averaging 1.77 veine/piece). CL main venous drainage is done mainly to the Middle Hepatic Vein (98.46% of the parts) and to the retrohepatic portion of the IVC (84.09%) (Supported by CNMP 41092/2007).