Accessory Hepatic Artery Arising from Celiac Trunk: An Incidence in a Thai Cadaver

Abstract

SUMMARY: An exhaustive knowledge of the liver vascular patterns as well as possible anatomical variations is significant in the planning and performance of all liver surgical procedures in order for the vascularity not to be disturbed or not causing necrosis of the liver parenchyma postoperatively. The celiac trunk usually provides three branches; left gastric, splenic and common hepatic arteries. The left and right hepatic arteries generally derive from proper hepatic artery which is a branch of common hepatic artery. To study the incidence of celiac trunk ramification, the branching patterns of the celiac trunk of 23 Thai cadavers (17 males, 6 females) were documented during routine dissection by medical students at the Department of Anatomy, Faculty of Medical Science, Naresuan University, Thailand. The clinically important variations of the celiac trunk were noted. The results showed that all celiac trunks arose from each aortas at the T12 vertebra (17.39%, 4 cases), intervertebral disc between T12 and L1 vertebra (78.26%, 18 cases) and upper 1/3 rd of L1 vertebra (4.35%, 1 case). We found 95.65% (22 cases) normal celiac trunk trifurcation; whereas, 4.35% (1 case) was abnormal quadrifurcation of the trunk. The accessory hepatic artery (aHA) was presented as an additional branch of celiac trunk because the conventional pattern of the left and right hepatic arteries was presented. This finding is one of the rare anatomical variations which is reported in available literatures. The awareness of celiac trunk and its stems aberrant is important in procedures such as liver transplant for appropriate vascular ligation and anastomosis.

A Study on Variations of Branching Pattern of Hepatic Arteries with its Clinical Significance

“…15 Similar to few authors there was not a single case of type III pattern in this study. [16][17][18] In contrast, many studies revealed type III variation and they recorded this configuration in15.16% and 16% respectively. 11,12 A study quoted the occurrence of this variant in majority (25%) of the studied cases.…”

An Unusual Anatomical Variation of Accessory Left Gastric Artery Arising from Left Hepatic Artery

“…Neglecting the variant gastric artery can cause damage to the gastric artery, leading to gastric ischemia. An anomalous branching pattern is often due to the original embryonic life, as explained by Chanasong et al (2014). During embryonic development, the stomach and liver are closely related.…”

The Hepatic Vasculature- A Clinical and Anatomical Correlation: A Case Report

“…The origin of the right hepatic artery from the superior mesenteric artery is very rare but forms an important clinical relation with the surrounding structures such as the head of the pancreas, first part of duodenum and portal vein, making it vulnerable during the surgeries. According to the study done by Chanasong et al, an additional accessory hepatic artery originated from the left aspect of the celiac trunk entering the porta hepatis of the liver in the Thai patient [9]. The cystic artery plays an important role in supplying the cystic duct and the gall bladder.…”