Jornal Vascular Brasileiro
Jornal Vascular Brasileiro
Case Report

Unusual development of the celiac trunk and its clinical significance

Desenvolvimento incomum do tronco celíaco e sua importância clínica

Serghei Covantev; Natalia Mazuruc; Irina Drangoi; Olga Belic

Downloads: 2
Views: 861


Abstract: We describe a case of unusual development of the celiac trunk observed in the cadaver of 1-year old male child. The celiac trunk branched into five vessels: the splenic, common hepatic and left gastric arteries, the left inferior diaphragmatic artery, and a short trunk that branched into the right inferior diaphragmatic artery and right accessory hepatic artery. Additionally, the manner of branching of the vessel was unusual: it was possible to distinguish two branching points that corresponded to its s-shaped trajectory. There were also other variations of vascular supply, such as the presence of a left accessory hepatic artery, an additional superior pancreatoduodenal artery, and others. It should be noted that multiple developmental variations can be common in clinical practice and clinicians should be aware of them during diagnostic and interventional procedures.


celiac trunk, accessory left hepatic artery, accessory right hepatic artery, additional superior pancreatoduodenal artery


Resumo: Apresentamos um relato de caso de desenvolvimento incomum do tronco celíaco em um cadáver do sexo masculino de 1 ano de idade. O tronco celíaco ramificou-se para cinco vasos: as artérias esplênica, hepática comum e gástrica esquerda, a artéria diafragmática inferior esquerda e um tronco pequeno que se ramificou para a artéria diafragmática inferior direita e para a artéria hepática direita acessória. Além disso, a forma como o vaso se ramificou foi incomum: é possível distinguir dois pontos de ramificação que correspondem à trajetória em formato de S. Também houve outras variações do suprimento vascular, como a presença da artéria hepática esquerda acessória, da artéria pancreaticoduodenal superior acessória e outras. Cabe observar que a variação de desenvolvimento múltipla pode ser comum na prática clínica, e os médicos devem estar cientes dela durante os procedimentos de diagnóstico e intervenção.


tronco celíaco, artéria hepática esquerda acessória, artéria hepática direita acessória, artéria pancreaticoduodenal superior acessória


1 Pinal-Garcia DF, Nuno-Guzman CM, Gonzalez-Gonzalez ME, Ibarra-Hurtado TR. The celiac trunk and its anatomical variations: a cadaveric study. J Clin Med Res. 2018;10(4):321-9. PMid:29511421.

2 Venieratos D, Panagouli E, Lolis E, Tsaraklis A, Skandalakis P. A morphometric study of the celiac trunk and review of the literature. Clin Anat. 2013;26(6):741-50. PMid:22886953.

3 Belic O, Mazuruc N, Covantev S. Anatomical variations of the splenic artery. Online J Health Allied Sci. 2017;16(2):19.

4 Araujo SA No, Franca HA, Mello CF Jr, et al. Anatomical variations of the celiac trunk and hepatic arterial system: an analysis using multidetector computed tomography angiography. Radiol Bras. 2015;48(6):358-62. PMid:26811552.

5 Adachi B. Das Arteriensystem der Japaner. Kyoto: Verlag der Kaiserlich-Japanischen Universitat zu Kyoto; 1928. (vol. 2).

6 Morita M. Reports and conception of three anomalous cases on the area of the celiac and superior mesenteric arteries. Igaku kenkyu. Acta Med. 1935;9:1993-2006.

7 Ramesh Babu CS, Joshi S, Gupta KK, Gupta OP. Celiacomesenteric trunk and its variants a multidetector row computed tomographic study. J Anat Soc India. 2015;64(1):32-41.

8 Huang Y, Mu G-C, Qin X-G, Chen Z-B, Lin J-L, Zeng Y-J. Study of celiac artery variations and related surgical techniques in gastric cancer. World J Gastroenterol. 2015;21(22):6944-51. PMid:26078572.

9 Singh BGP, Bhatt CR, Patel SV, Mehta CD. Morphometric study of coeliac trunk specific reference to hepatic artery pattern in the west-indian population. Indian J Surg. 2014;76(5):359-62. PMid:26396468.

10 Liang Y, Li E, Min J, Gong C, Wu L. Rare anatomic variation of the right hepatic artery and accessory right hepatic artery supplying hepatocellular carcinoma: a case report and literature review. Medicine. 2017;96(39):e8144. PMid:28953651.

11 Song SY, Chung JW, Yin YH, et al. Celiac axis and common hepatic artery variations in 5002 patients: systematic analysis with spiral CT and DSA. Radiology. 2010;255(1):278-88. PMid:20308464.

12 Aslaner R, Pekcevik Y, Sahin H, Toka O. Variations in the origin of inferior phrenic arteries and their relationship to celiac axis variations on CT angiography. Korean J Radiol. 2017;18(2):336-44. PMid:28246513.

13 Gürses İA, Gayretli Ö, Kale A, Öztürk A, Usta A, Şahinoğlu K. Inferior phrenic arteries and their branches, their anatomy and possible clinical importance: an experimental cadaver study. Balkan Med J. 2015;32(2):189-95. PMid:26167344.

14 Gonsalves CF, Brown DB. Chemoembolization of hepatic malignancy. Abdom Imaging. 2009;34(5):557-65. PMid:18668189.

15 Gwon DI, Ko GY, Yoon HK, et al. Inferior phrenic artery: anatomy, variations, pathologic conditions, and interventional management. Radiographics. 2007;27(3):687-705. PMid:17495287.

16 Kim HC, Chung JW, An S, et al. Left inferior phrenic artery feeding hepatocellular carcinoma: angiographic anatomy using C-arm CT. AJR Am J Roentgenol. 2009;193(4):W288-94. PMid:19770297.

17 Takanami I. Massive haemoptysis due to chronic pancreatitis: control with inferior phrenic artery embolization. Eur J Cardiothorac Surg. 2000;18(1):120-2. PMid:10869951.

18 Michels NA. Newer anatomy of the liver and its variant blood supply and collateral circulation. Am J Surg. 1966;112(3):337-47. PMid:5917302.

19 Hiatt JR, Gabbay J, Busuttil RW. Surgical anatomy of the hepatic arteries in 1000 cases. Ann Surg. 1994;220(1):50-2. PMid:8024358.

20 Mazuruc N, Covantev S, Belic O. A case of unusual vascularization of upper abdominal cavity’ organs. Case Rep Vasc Med. 2018;2018:5738037. PMid:30515342.

21 Noussios G, Dimitriou I, Chatzis I, Katsourakis A. The main anatomic variations of the hepatic artery and their importance in surgical practice: review of the literature. J Clin Med Res. 2017;9(4):248-52. PMid:28270883.

22 Sureka B, Mittal MK, Mittal A, Sinha M, Bhambri NK, Thukral BB. Variations of celiac axis, common hepatic artery and its branches in 600 patients. Indian J Radiol Imaging. 2013;23(3):223-33. PMid:24347852.

23 López-Andújar R, Moya A, Montalvá E, et al. Lessons learned from anatomic variants of the hepatic artery in 1,081 transplanted livers. Liver Transpl. 2007;13(10):1401-4. PMid:17902125.

24 Okano S, Sawai K, Taniguchi H, Takahashi T. Aberrant left hepatic artery arising from the left gastric artery and liver function after radical gastrectomy for gastric cancer. World J Surg. 1993;17(1):70-3, discussion 74. PMid:8447143.

25 Zanon C, Grosso M, Clara R, Chiappino I, Mancini A, Mussa A. Percutaneous implantation of arterial Port-a-cath via trans-subclavin access. Anticancer Res. 1999;19(6C):5667-71. PMid:10697638.

26 Bertelli E, Di Gregorio F, Bertelli L, Civeli L, Mosca S. The arterial blood supply of the pancreas: a review. Surg Radiol Anat. 1996;18(1):1-9. PMid:8685804.

Submitted date:

Accepted date:

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
604bc80aa95395646a4e8fc3 jvb Articles
Links & Downloads

J Vasc Bras

Share this page
Page Sections