An arc of Bühler variant

The celiaco-mesenteric anastomoses occur either directly between the celiac trunk and the superior mesenteric artery (SMA), or between different branches of them. A rarely occurring such anastomosis is the arc of Bühler. A new variant of arc of Bühler was found incidentally during a retrospective study of the computed tomography angiograms of a 62 y.o. male patient. In that case, the arc of Bühler left from the splenic artery and inserted into the inferior pancreaticoduodenal artery (IPDA), proximally to the IPDA division into its anterior and posterior branches. Moreover, that arc of Bühler was giving off a mesenterico-jejunal branch, which descended applied on the anterior side of the SMA. Such anatomic variants could impede on the surgical or interventional procedures in the duodenopancreatic region, or could be physiologically useful to divert the celiac flow towards the mesenteric territory, or vice versa.