Celiacomesenteric Trunk: A Variation That Must Be Known Before Aortic Surgery

Abstract

The celiac trunk and the mesenteric arteries may present variations with different clinical significance. A celiacomesenteric trunk was discovered in a patient with mesenteric ischemia and a history of aortic bypass without inferior mesenteric artery reimplantation. Despite thrombectomies and digestive resections, the patient died. Anatomic variations like celiacomesenteric trunk must be known before aortic surgery.

Celiomesenteric trunk demonstrated by multi-detector computed tomography angiography: two cases of a rare vascular variation

“…CMT is usually asymptomatic and may be discovered incidentally during vascular surgery [1,15], radiologic imaging [8], or cadaver's dissection [10]. Symptoms are rare and vary between unspecific abdominal pain and real abdominal angina, when associated to atherosclerosis [1].…”

“…The celiac trunk usually arises from the ventral part of the aorta at the level of the 12 th thoracic vertebra and it branches off the left gastric, common hepatic and splenic arteries [10]. The superior mesenteric artery arises 1 cm below, at the level of the first lumbar vertebrae [1].…”

“…The celiomesenteric trunk (CMT) is a rare congenital vascular variation in which the celiac trunk and the superior mesenteric artery (SMA) arise off a common vessel from the ventral part of the aorta [2,10,16]. Its incidence is less than 1% of all celiomesenteric anomalies [4] and less than 2% of all individuals [16].…”

Celiaco Mesenteric Trunk - A Case Report

“…This kind of vascular variations has to be known to surgeons and radiologists because it may change the management. 8 Normal Celiac trunks exhibiting trifurcation have been reported with a frequency of 72-90% in the normal population. 6 Celiac trunk bifurcation as an anatomical variation has been reported at a rate of about 12% in the literature.Bergman et al published a metaanalysis of "no Celiac trunk reports" in the literature and calculated the average absence rate of celiac trunk as 0.4%.…”

Celiacomesenteric trunk and its variants a multidetector row computed tomographic study

“…9 Thrombosis of the CMT leading to a lethal effect on the patients because of complete cessation of splanchnic arterial supply and consequent ischemia of supramesocolic organs was also reported. 10,11 Presence of CMT is associated with intrinsic loss of CA-SMA collateral circulation, which is an important safeguard protecting against mesenteric ischemia, thus leaving a large segment of bowel with one dominant vascular feed. Compression of the CMT by the median arcuate ligament of the diaphragm resulting in clinical symptoms like epigastric pain, weight loss has also been reported in the literature.…”