A morphometric study of the celiac trunk and review of the literature

Abstract

The anatomy of the celiac trunk and its branches was examined in 77 adult human cadavers of Caucasian (Hellenic) origin. The celiac trunk followed the normal pattern, namely trifurcation to the common hepatic, splenic, and left gastric arteries, in 90.9% of the dissections (70/77). Two different types of trifurcation were observed: (a) a true tripod when the celiac trunk ended in a complete trifurcation (74.0%, 57/77) and (b) a false tripod when the three arteries did not have a common origin (16.9%, 13/77). Such a clear predominance of the true tripod is not reported elsewhere. Anatomic variations were found in 9.1% (7/77). Bifurcation of the celiac trunk into splenic and left gastric artery (splenogastric trunk) was observed in one specimen (1.3%), whereas the common hepatic artery emerged directly from the aorta. Absence of the celiac trunk was also found in two individuals (2.6%). The celiac trunk presented additional branches (lumbar and inferior phrenic arteries) in 5.2% (4/77). The median level of origin of the celiac trunk was at the upper third of L1 (22.7% to 17/75). The total length of the celiac trunk ranged from 1.1 to 5.0 cm, whereas the mean length was 2.8 cm (standard deviation = 0.80 cm, standard error of mean = 0.09 cm) irrespective of the existence of variations. The mean length of the celiac arteries which formed a false tripod was found to be larger than those of the arteries which formed a true tripod but only a weak statistically significant difference was established (P = 0.073).

Morphometric analysis of the vertebral level of origin of the coeliac trunk and its length

“…5 Similar observation was made in our study where false tripod branching group had longer length of CT. In our study majority of the cadavers had false tripod pattern of CT branching.…”

Massive upper gastrointestinal bleeding from an accessory splenic artery mimicking isolated gastric varices

“…In the later weeks, these arteries gradually fuse to form coeliac trunk, superior mesenteric and inferior mesenteric arteries in the dorsal mesentery of the gut, which are present in adult life [7,15]. The anatomical variations of the coeliac trunk observed in the present study may result from the persistence of normally disappearing branch/branches or incomplete fusion or malfusion among these primitive arteries.…”

Absence of the celiac trunk in a rectal cancer patient: case report

“…[1] Its average length is 1-3 cm and average diameter 5-8 mm. [2][3][4][5] Trifurcation of the CT was first described by Haller in 1756 and named 'Tripus Halleri'.…”

“…Since then it is considered as a normal anatomical form. [1,3,6] According to Haller, the CT has three branches: common hepatic artery (CHA) which supplies the liver, left gastric artery (LGA) which supplies the stomach, and the splenic artery (SA) which usually arises as tributary elsewhere in this trunk supplying the spleen. The other divisions of CT rarely occur in the human.…”

“…The other divisions of CT rarely occur in the human. [1,[3][4][5] Variations of the arteries of the CT and their relationship to surrounding structures are of particular importance from a surgical perspective. [3] Currently, frequent use of diagnostic and interventional radiologic modalities allows clinicians to diagnose such vascular variations easily.…”