[Epiploic arteries. Normal and pathological radiological appearances (author's transl)]

Area of Science:

• Vascular anatomy
• Gastrointestinal radiology
• Surgical pathology

Background:

• The greater omentum's vascular supply is crucial for understanding abdominal pathology.
• Previous descriptions of its arterial circle remain debated.
• Digestive angiography offers detailed visualization of visceral vasculature.

Purpose of the Study:

• To investigate the vascular anatomy of the greater omentum using selective digestive angiography.
• To correlate radiological findings with anatomical variations.
• To elucidate the omentum's role in pathological conditions.

Main Methods:

• Selective digestive angiography performed on 450 cases.
• Comparison of angiographic images with anatomical dissections.
• Analysis of pathological findings related to the greater omentum.

Main Results:

• Identified two independent right and left vascular systems of the greater omentum with variable sizes.
• Demonstrated variable anastomoses between these systems, often difficult to visualize arteriographically.
• The classical gastro-epiploic arterial circle was consistently absent.
• Epiploic metastases were the most frequent tumoral pathology, contraindicating laparotomy.
• The omentum showed reactive changes (e.g., sentinel loop) to abdominal infections and neoplasms.

Conclusions:

• The greater omentum's blood supply is characterized by independent right and left systems with variable connections.
• Arteriography is valuable for diagnosing omental metastases and associated abdominal pathologies.
• Understanding omental vascularity aids in interpreting radiological findings and guiding clinical decisions.