Anatomical variations of the celiac trunk and its branches are particularly important from a surgical perspective due to their relationships with surrounding structures. We report here a particularly rare variant involving absence of the celiac trunk in association with trifurcation of the common hepatic artery. These variations were found in an adult male cadaver. We perform a review of the literature and discuss the clinical and embryological significance of these variations. Recognition of celiac trunk and hepatic artery variations is of utmost importance to surgeons and radiologists because multiple variations can lead to undue complications.

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Suprarenal vascular variations should be known to surgeons performing laparoscopic adrenalectomy, partial nephrectomy, living donor nephrectomy and renal transplantation. A rare case of vascular variation of the left suprarenal gland was observed, in which the left suprarenal vein was draining into the inferior vena cava after crossing the abdominal aorta anteriorly, just below the origin of the superior mesenteric artery. The left inferior suprarenal artery was originating from the left gonadal artery, which originated from the abdominal aorta in front of the left renal artery. Besides this, the left renal vein passed obliquely downwards behind the abdominal aorta and drained into the inferior vena cava. The retroaortic left renal vein may lead to unilateral hematuria, left varicocele and could be a cause of infertility in men.

IntroductionLigamentum teres hepatis, an embryological remnant derived from the obliterated left umbilical vein is lodged on the fissure for the ligamentum teres on the inferior surface of the liver. We report here an anomalous case where the ligament passed through a tunnel instead of a fissure. Case reportThe fissure for ligamentum teres was obliterated by bridging of liver tissue across the quadrate and left lobes. This bridging converted the fissure into a tunnel through which ligamentum teres coursed to its destination. A small fissure extended from the left end of porta hepatis to this tunnel. Lack of separation of lobes, in the early embryonic period might have led to this variation. ConclusionAnomalies like this can often mislead the radiologists or surgeons either in diagnosis or interpretations of liver diseases.