Coeliac trunk origin of bilateral inferior phrenic arteries

The bilateral inferior phrenic arteries supply the diaphragm, the suprarenal glands and the abdominal oesophagus. They typically originate from the abdominal aorta, superior to the coeliac trunk origin, and ascend to the inferior surface of the diaphragm. Variations in their anatomy are common and may contribute to hepatocellular carcinomas' vascularisation or increase the risk of iatrogenic injury during abdominal procedures. Existing studies are geographically limited and restricted to non-European populations. To date, no published data describing inferior phrenic arterial variations within a Scottish population. This study aims to investigate the origin, course and branching patterns of the inferior phrenic arteries in Scottish cadavers.

Six formalin-embalmed human cadavers (mean age 87.3 years) from the Anatomy, Edinburgh Medical School, regulated by the Human Tissue (Scotland) Act 2006. The abdominal region was dissected to reveal the abdominal aorta and its branches. The origin, course and branches of the left and right inferior phrenic arteries were observed and documented.

Bilateral inferior phrenic arteries from two female donors (n = 4, 33.33%) originated from the coeliac trunk. The inferior phrenic arteries ran anterosuperiorly and laterally to supply the suprarenal glands and the inferior surface of the diaphragm. The remaining eight (66.67%) inferior phrenic arteries emerged from the abdominal aorta bilaterally.

Inferior phrenic arteries with a coeliac trunk origin were found in a third of the Scottish cadaver samples. Knowledge of these variations is crucial to minimising incomplete hepatocellular carcinoma embolization and iatrogenic injuries during upper abdominal surgeries, possibly resulting in haemothorax.