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Unique Hepatic Arterial Pattern Associated With the Presence of Accessory Proper Hepatic Artery and Middle Hepatic
Yashwanth Duddu1, Alka V Bhingardeo1, Srija Darna1
1Anatomy, All India Institute of Medical Sciences, Bibinagar, Hyderabad, IND.
Insights
A novel coeliac trunk variation features a common hepatic artery trifurcation not previously recorded. This unique vascular anatomy impacts liver segmentation and surgical planning.
Area of Science:
- Vascular anatomy
- Surgical anatomy
- Hepatic artery variations
Background:
- Coeliac trunk variations are common, including CHA trifurcation and accessory/replaced hepatic arteries.
- Accurate anatomical knowledge is vital for hepatobiliary and pancreatic surgery.
Observation:
- A rare coeliac trunk variation presented a unique CHA trifurcation into PHA, GDA, and APHA.
- The APHA supplied the right liver lobe, and an MHA originated from the PHA, draining segment IV.
Findings:
- This specific trifurcation pattern is novel and does not fit existing coeliac trunk classifications.
- The identified variant includes an accessory PHA branching to the right lobe and an MHA from the PHA.
Implications:
- Understanding this variant is critical for liver transplantation and pancreatic/gallbladder surgeries.
- Knowledge of this anatomy aids in interventional radiology procedures like chemoembolization and radionuclide therapy.
Abstract:
Vascular variations of the coeliac trunk are relatively common, with documented occurrences including trifurcation of the common hepatic artery (CHA) and the presence of accessory and replaced hepatic arteries. This case report describes a novel variation wherein the CHA trifurcates into the proper hepatic artery (PHA), gastroduodenal artery, and accessory PHA (APHA). This particular trifurcation pattern has not been previously recorded. The APHA further branches into two arteries that supply the right lobe of the liver. Additionally, a middle hepatic artery (MHA), originating from the PHA, was identified alongside the right and left hepatic arteries. The MHA serves as a hilar artery that drains segment IV of the liver. This anatomical variant does not conform to any existing coeliac trunk classifications. Understanding this unique arterial pattern is crucial for liver transplantation, as well as procedures involving the pancreas, duodenum, and gallbladder, and for interventional techniques such as transcatheter arterial chemoembolization and transarterial radionuclide therapy.
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