Common stem origin of left gastric, right and left inferior phrenic arteries, in association with a hepatosplenomesenteric trunk, independently arising from the abdominal aorta: Case report using MDCT angiography

Abstract

We describe in this paper a rare case of a 45-year-old male with a common stem origin of the left gastric artery (LGA), right inferior phrenic artery (RIPA), and left inferior phrenic artery (LIPA), in association with the presence of a hepatosplenomesenteric trunk (HSMT) arising from the abdominal aorta (AA), as revealed by routine multidetector computed tomography (MDCT) angiography. The common stem origin of the LGA, RIPA, and LIPA had an endoluminal diameter of 3.3 mm, the LGA of 2.8 mm. The endoluminal diameter of the RIPA and LIPA was at the origin of approximately 1 mm, complicating selective chemoembolization of the liver parenchyma.

Anatomical variations of the coeliac trunk in the homogeneous Polish population

“…Anatomical variations of the coeliac trunk and other branches of the abdominal aorta results from foetal developmental changes in the ventral segmental arteries supplying the digestive tube [16]. The roots 10 th -13 th give origin for the left gastric artery, common hepatic artery, splenic artery, and SMA, respectively.…”

Common and separate origins of the left and right inferior phrenic artery with a review of the literature

“…The anatomy and embryological development of the left gastric artery (LGA) and inferior phrenic artery (IPA) are complicated because of the complex embryogenesis and collocated relationships with the abdominal aorta and coeliac trunk (CT) [15,16]. The normal pattern of the CT constituted by the LGA, splenic artery, and common hepatic artery was present in 87.94% of cases in a summary of 8 studies [16].…”

“…The normal pattern of the CT constituted by the LGA, splenic artery, and common hepatic artery was present in 87.94% of cases in a summary of 8 studies [16]. The IPA arises from each side of the abdominal aorta or CT just under the diaphragm, most often between the T12 and L2 vertebra [6,23].…”

“…There are also anomalies wherein the IPAT arises from the gastrophrenic trunk (GPT), renal-phrenic trunk, coeliacomesenteric trunk, or GPT [4, 8, 9, 14, 16-19, 22, 24, 26, 28-30]. Moreover, there are several reports regarding the anatomy of the GPT [9,16,22,29]. First, the GPT branches from the abdominal aorta, and then it branches to the IPAT and LGA [9,16,22,29].…”

“…First, the GPT branches from the abdominal aorta, and then it branches to the IPAT and LGA [9,16,22,29]. Variations in the branches of the IPAT and LGA from the GPT are also common [9,16,22,29].…”