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Pentafurcated Celiac Trunk.

Mugurel Constantin Rusu1, Bogdan Adrian Manta1

  • 1Division of Anatomy, Department 1, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.

Annals of Vascular Surgery
|August 16, 2020
PubMed
Summary
This summary is machine-generated.

A rare pentafurcation of the celiac trunk (pCT) with an accessory hepatic artery from the superior mesenteric artery was identified. This unique vascular anatomy, visualized via computed tomography angiography, highlights the importance of detailed imaging before abdominal interventions.

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Area of Science:

  • Vascular anatomy
  • Radiology
  • Surgical anatomy

Background:

  • The celiac trunk (CT) typically trifurcates into the left gastric, common hepatic, and splenic arteries.
  • Variations in CT branching, particularly pentafurcations (pCT), are exceptionally rare in anatomical literature.
  • Previous reports of pCT predominantly stem from cadaveric dissections.

Observation:

  • This study reports a rare case of celiac trunk pentafurcation (pCT) identified in a 71-year-old female patient using computed tomography angiography.
  • The observed pCT exhibited three collateral branches (two ascending, one descending) and two terminal branches.
  • A notable finding was an accessory right hepatic artery originating from the superior mesenteric artery (SMA).

Findings:

  • The pCT gave rise to the left inferior phrenic artery, a secondary hepatogastric trunk (with a replaced left hepatic artery and left gastric artery), and the dorsal pancreatic artery.
  • The pCT terminated into the common hepatic artery (CHA) and splenic artery (SA).
  • The CHA bifurcated into the gastroduodenal and right hepatic arteries, while the SMA supplied an accessory right hepatic artery.

Implications:

  • The simultaneous occurrence of a pCT and an SMA-derived hepatic artery, resulting in three main hepatic arteries, has not been previously documented.
  • Detailed computed tomography (CT) documentation of anomalous celiac trunk branching is crucial for surgical and interventional procedures in the celiac region.
  • Awareness of such rare vascular variations is essential for preventing intraoperative complications and ensuring patient safety.