Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492010005000006
Jornal Vascular Brasileiro
Original Article

Accessory hepatic artery: incidence and distribution

Artéria hepática acessória: incidência e distribuição

Sukhendu Dutta; Bimalendu Mukerjee

http://dx.doi.org/10.1590/S1677-54492010005000006 J Vasc Bras, vol.9, n1, p.25-27, 2010
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Abstract

Background: Anatomic variations of the hepatic arteries are common. Preoperative identification of these variations is important to prevent inadvertent injury and potentially lethal complications during open and endovascular procedures. Objective: To evaluate the incidence, extra-hepatic course, and presence of side branches of accessory hepatic arteries, defined as an additional arterial supply to the liver in the presence of normal hepatic artery. Methods: Eighty-four human male cadavers were dissected using a transperitoneal midline laparotomy. The supra-celiac aorta, celiac axis, and hepatic arteries were dissected, and their trajectories were identified to describe arterial branching patterns. Results: Normal hepatic arterial anatomy was identified in 95% of the cadavers and six (5%) had accessory hepatic arteries. In five cadavers the accessory hepatic artery followed its course through the fissure for ligamentum venosum, and in one it coursed adjacent to the hepatic artery through the margin of the lesser omentum. One cadaver had a single side branch, which provided arterial blood supply to the left adrenal gland in the absence of any left inferior phrenic artery. Conclusion: Accessory hepatic artery most often follows the course of the hepatic fissure for ligamentum venosum. Albeit uncommonly found in 5% of cases, this finding should be identified during open and endovascular procedures to prevent inadvertent injury.

Keywords

Liver-arterial supply, celiac trunk, accessory hepatic artery, suprarenal artery

Resumo

Contexto: As variações anatômicas das artérias hepáticas são comuns. A identificação pré-operatória dessas variações é importante para prevenir lesão inadvertida e complicações potencialmente letais durante procedimentos abertos e endovasculares. Objetivo: Avaliar a incidência, o trajeto extra-hepático e a presença de ramos laterais das artérias hepáticas acessórias definidas como um suprimento arterial adicional para o fígado na presença de artéria hepática normal. Métodos: Oitenta e quatro cadáveres humanos masculinos foram dissecados através de laparotomia mediana transperitoneal. A aorta supracelíaca, o eixo celíaco e as artérias hepáticas foram dissecados, e suas trajetórias foram identificadas para descrever os padrões dos ramos arteriais. Resultados: Anatomia arterial hepática normal foi identificada em 95% dos cadáveres, e seis (5%) tinha artérias hepáticas acessórias. Em cinco cadáveres, a artéria hepática acessória seguia seu trajeto através da fissura para o ligamento venoso, e em um caso a artéria corria adjacente à artéria hepática através da margem do pequeno omento. Um cadáver tinha um ramo unilateral que fornecia sangue arterial para a glândula adrenal esquerda na ausência de qualquer artéria frênica inferior esquerda. Conclusão: A artéria hepática acessória frequentemente segue o trajeto da fissura hepática para o ligamento venoso. Embora comumente encontrado em 5% dos casos, esse achado deve ser identificado durante procedimentos abertos e endovasculares para prevenir lesão inadvertida.

Palavras-chave

Suprimento arterial hepático, tronco celíaco, artéria hepática acessória, artéria suprarrenal

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