[Arterial collateral pathways in liver cirrhosis and celiac axis occlusion]

Area of Science:

• Vascular anatomy
• Hepatic circulation
• Interventional radiology

Background:

• Liver cirrhosis often leads to altered hemodynamics and potential vascular complications.
• Coeliac axis occlusion presents unique challenges in assessing visceral arterial supply.
• Replaced hepatic arteries require detailed anatomical understanding for surgical and interventional procedures.

Observation:

• A patient with liver cirrhosis presented with occlusion of the coeliac axis.
• A replaced right hepatic artery originating from the superior mesenteric artery was identified.
• Six distinct arterial pathways connecting the mesenteric and hepatosplenic circulations were visualized.

Findings:

• The study identified multiple collateral pathways between the superior mesenteric artery and the hepatic artery system.
• Demonstration of six arterial pathways highlights significant vascular adaptation in the presence of coeliac axis occlusion.
• Hepatofugal blood flow was confirmed, indicating blood moving away from the liver, despite concurrent portal hypertension.

Implications:

• Understanding these complex arterial variations is crucial for accurate diagnosis and treatment planning in patients with complex hepatic and mesenteric vascular issues.
• The findings emphasize the adaptability of the splanchnic circulation and the potential for extensive collateral formation.
• This case provides valuable anatomical insights for surgeons and interventional radiologists managing patients with liver disease and complex arterial anatomy.