Right gastroepiploic artery arising from the dorsal pancreatic artery: a very rare anatomic variation underlying interesting embryologic implications

Abstract

The exceptional case of the right gastroepiploic artery (RGE) arising from the dorsal pancreatic (DP) artery in an individual affected by hepatocellular carcinoma is presented. This anatomic variant was demonstrated with a selective angiography of the common hepatic artery that showed a distinct DP artery branching from the injected artery. The DP artery gave off regular pancreatic branches and continued as a long and winding vessel that was identified as the RGE by its general course, the anterior epiploic branches arising from it, and the injection of the distal splenic artery, possibly via the anastomosis with the left gastroepiploic artery. The anatomy of the RGE has few variations, mostly limited to its origin from the superior mesenteric artery. Arising of the gastroepiploic artery from the DP artery has never been previously reported and represents an unexpected possible anatomic variant of which general and heart surgeons should be aware. In particular, this case is of interest in surgical procedures involving resection of the head of the pancreas, gastrectomies or coronary artery bypass grafting using the RGE. The embryology underlying the development of this anatomic variation is reviewed.

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“…Gregorio FD et al found that the RGEA originated from the dorsal pancreatic artery, and Sakamoto H et al reported that the RGEA originated from the superior mesenteric artery. 21,22 In our study, the RGEA of all 50 patients in the CAS group originated from the GDA without any variation. However, there were obvious differences in the diameters of the RGEA; therefore, we divided the patients into a coarse blood supply type and a fine blood supply type.…”