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Incomplete celiac trunk with replaced hepatic arteries: a rare cadaveric case and embryologic interpretation
Chaelin Oh1, Hojoong Kang1, Jeongtae Kim
1Medical Course, College of Medicine, Jeju National University, Jeju, South Korea.
Insights
A rare combined anatomical variation of the celiac trunk and superior mesenteric artery (SMA) was found. This discovery highlights unique vascular patterns and aids in preventing surgical injury.
Area of Science:
- Anatomy
- Vascular Biology
- Embryology
Background:
- The celiac trunk and superior mesenteric artery (SMA) share developmental origins, leading to interconnected variations.
- Combined anatomical variations of these major arteries and their branches are infrequently documented.
Purpose of the Study:
- To report a rare, combined anatomical variation involving the celiac trunk, SMA, and their branches.
- To enhance understanding of embryologic basis for vascular anomalies.
Main Methods:
- A case report detailing a unique vascular variation identified during routine cadaveric dissection.
- Analysis of the celiac trunk, SMA, and associated arterial branches.
Main Results:
- Identification of an incomplete celiac trunk and a hepato-mesenteric trunk.
- Specific variations included a gastro-hepatic trunk, a gastroduodenal-splenic trunk, absence of the common hepatic artery, and a hepato-mesenteric trunk supplying replaced hepatic arteries and the SMA.
- The identified replaced hepatic arteries align with Type IV variants but do not account for the incomplete celiac trunk.
Conclusions:
- This case presents a unique combined variation of the celiac trunk, SMA, and their branches.
- Awareness of such embryologic variations is crucial for minimizing iatrogenic vascular injury during abdominal surgeries.
Background:
The celiac trunk and superior mesenteric artery (SMA) are developmentally interconnected, and variations in one system often directly influence the other. Although classifications have been proposed for each structure, combined variations involving the celiac trunk, SMA, and their branches remain rare.
Case Report:
We report combined variations involving the celiac trunk, SMA, and their branches, identified during routine educational dissection of an 80-year-old male cadaver in 2025.
Results:
A rare combined vascular variation comprising an incomplete celiac trunk and a hepato-mesenteric trunk was identified: (1) a gastro-hepatic trunk that bifurcated into the left gastric artery and a replaced left hepatic artery; (2) a gastroduodenal- splenic trunk that bifurcated into the gastroduodenal artery and splenic artery; (3) absence of the common hepatic artery; and (4) a hepato-mesenteric trunk that gave rise to a replaced right hepatic artery and then continued as the SMA. The replaced hepatic arteries correspond to the type IV variant in the Michels and Hiatt classifications, which do not account for an incomplete celiac trunk.
Conclusions:
This case demonstrates a unique combined variation involving an incomplete celiac trunk, the SMA, and their branches. Awareness of such patterns and their embryologic basis may reduce iatrogenic vascular injury during upper abdominal and hepatobiliary procedures.
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