Celiomesenteric trunk: Two variants of a rare anomaly

Abstract

The celiomesenteric trunk is a rare congenital vascular anomaly characterized by a common origin of the celiac axis and superior mesenteric artery. We report two variants: one in which the left gastric artery arises from a short common trunk and a second where the left gastric artery originates directly from the aorta above the common trunk. We discuss a possible embryologic mechanism for formation of these variants and the clinical implications. These cases also illustrate the ability of multidetector CT to provide quality images of such vascular anomalies.

Celiomesenteric trunk demonstrated by multi-detector computed tomography angiography: two cases of a rare vascular variation

“…To the best of the authors knowledge, only 3 other cases of CMT detected by MDCTA has been described [11,16,23]. DSA has been the gold standard for the evaluation of the abdominal aorta and its branches, for years.…”

“…In the literature there are 2 reports of the short CMT variant, the one detected on MDCTA [16] and the other discovered during anatomic dissection of a cadaver [3]. This variant may be underdiagnosed with angiography as it quite difficult to discern a short CMT from a common origin of the SMA and the celiac trunk, as the tip of the catheter may easily transverse the common trunk and enter the orifice of one of its branches [16]. This could explain the few reports of this variant to the literature [16].…”

“…The whole blood supply to the major abdominal viscera may be at risk in any disorder involving the CMT trunk, especially in cases of atherosclerosis or vascular interventional procedures complications [16]. Furthermore, in patients with arterial variants there is an increased risk of hepatic artery complications after liver transplantation [2], as well as there has been reported increased complication rates during chemoembolisation in patients with variant of the mesenteric arterial anatomy [16].…”

“…Its incidence is less than 1% of all celiomesenteric anomalies [4] and less than 2% of all individuals [16].…”

“…The celiomesenteric trunk (CMT) is a rare congenital vascular variation in which the celiac trunk and the superior mesenteric artery (SMA) arise off a common vessel from the ventral part of the aorta [2,10,16]. Its incidence is less than 1% of all celiomesenteric anomalies [4] and less than 2% of all individuals [16].…”