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Anatomic variants of the celiac trunk and hepatic artery: insights from abdominal CT imaging
Muluken Yifru Gebresilassie1, Hawi Dida Midekso2, Abdudin Heru Mehammed3
1Department of Radiology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. muluken.yifru@sphmmc.edu.et.
Insights
Anatomical variations of the celiac trunk and hepatic arteries are common in the Ethiopian population. Awareness of these variations is crucial for surgeons to prevent complications during abdominal procedures.
Area of Science:
- Anatomical variations
- Vascular anatomy
- Surgical anatomy
Background:
- The celiac trunk and hepatic arteries exhibit diverse anatomical variations.
- Understanding these variations is vital for minimizing complications in abdominal surgeries.
- Contrast-enhanced abdominal CT is effective for preoperative assessment of these variants.
Purpose of the Study:
- To document the types of celiac trunk and hepatic artery variations in the Ethiopian population.
- To provide data that can help reduce morbidity and mortality associated with these anatomical variants.
Main Methods:
- A retrospective chart review of 290 triphasic abdominal MDCTs performed between June 2023 and May 2024.
- Data collected by radiologists from CT images.
- Statistical analysis using SPSS version 27.
Main Results:
- A normal trifurcation pattern (Uflacker type I) of the celiac trunk was observed in 84.83% of cases.
- The most common celiac trunk variant was the gastro-splenic trunk (Uflacker type V) at 7.24%.
- Normal hepatic artery origin (Michel type I) occurred in 69.7%, with Michel type V being the most frequent variant (9.31%).
- Unclassified variations were also identified.
Conclusions:
- Variations in celiac trunk and hepatic artery anatomy are prevalent.
- Significant correlations were found between variations in right and left hepatic arteries.
- Radiologists and surgeons should be aware of these specific variations to improve patient outcomes.
Background:
The celiac trunk is the first anterior branch of abdominal aorta. Celiac trunk and hepatic arteries show several variations in origin and course, knowledge of which is important during open and laparoscopic surgeries. Preoperative assessment of variants helps to reduce complications like vascular bleeding. The celiac trunk and hepatic artery branching patterns can be assessed with contrast-enhanced abdominal CT. This study will offer the types of variants observed in the Ethiopian population, helping to mitigate the morbidity and mortality associated with variant anatomies.
Methods:
A hospital-based retrospective chart review study was conducted from June -August 2024, among patients who underwent abdominal MDCT from June 2023 to May 2024. A total of 290 triphasic abdominal MDCTs were included in the study using a single-proportion population formula. The data was collected from abdominal CT images by radiologists. The data was managed with epi-info, and descriptive and comparative inferential statistics were done by SPSS version 27.
Results:
About 84.83% of the cases showed a normal trifurcation pattern of the celiac trunk (Uflacker type I), with the commonest variant being the gastro-splenic trunk (Uflacker type V), with a 7.24% incidence. Regarding the hepatic artery, 69.7% of the cases showed the normal origin of the hepatic arteries (Michel type I), with the commonest variant being Michel type V with a 9.31% incidence. Some cases are discovered that were not previously described by Michel's classifications.
Conclusion:
Our study revealed that variations in the celiac trunk and hepatic arteries are common. Significant correlations between variant right and left hepatic arteries were noted. We recommend that interventional and body imaging radiologists, as well as hepatobiliary and liver transplant surgeons, be aware of the specific variations in the celiac trunk and hepatic arteries to mitigate associated complications.
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