A rare variant of type XI in the Michels classification of common hepatic artery branching

Anatomical abnormalities affecting the branches of the common hepatic artery (CHA) and thus affecting the blood supply to the liver and surrounding organs, pose a challenge for specialists performing interventions in the upper abdomen. It therefore seems essential to continually expand knowledge of new or less common variants such as the one presented in this case.

A rare CHA branching pattern was observed during routine dissection of an 82-year-old male cadaver. Vessel measurements were performed twice by two investigators using a digital caliper with an accuracy of 0.02 mm. The reported values were the means of the two measurements. There were no visible signs of postoperative scarring from procedures performed during life.

The CHA, arising from the celiac trunk (CT), measured 5.43 mm in diameter and 28.27 mm in length. The gastroduodenal artery (GDA), right hepatic artery (RHA), and left hepatic artery (LHA), which branched from the CHA, measured 4.38 mm, 6.13 mm, and 3.27 mm in diameter, respectively. The RHA gave off the cystic artery (CA) (diameter, 2.80 mm) and a middle hepatic artery (MHA) (diameter, 1.67 mm). The LHA gave rise to the right gastric artery (RGA) (diameter, 1.91 mm) and an MHA (diameter, 3.92 mm). This branching pattern was classified as type XI in the Michels classification. We did not identify a similar previously described variation.

Although these findings are extremely rare, they are significant in transplantation, surgery, and radiology of the upper abdomen. It is important to expand anatomical knowledge and document identified variants to improve the quality of medical care.