Incidence and Surgical Importance of the Posterior Gastric Artery

Abstract

In a series of 61 adult cadavers, the posterior gastric artery was found in 38 (62.3%), originating from the superior aspect of the mid-third of the splenic artery. The posterior gastric artery, running behind the parietal peritoneum of the omental bursa, produced a peritoneal fold before reaching the posterior wall of the superior portion of the gastric body, near the cardiac region, and the fundus. Its high incidence, hidden origin, deep course, and distribution make this artery very important for surgical procedures relating to the stomach, pancreas, spleen, and celiac region. It may be crucial, especially if partial gastric resection of splenectomy have obliterated other gastric vessels.

Incidence, Anatomy and Territories Supplied by the Posterior Gastric Artery

“…Like DiDio et al [7] we could not find significant differences in the sex distribu tion. The course of the PGA from the splenic artery towards the posterior gastric wall corresponded to the description given by Suzuki et al [26]. In our study, one third of the PGAs had a branch from the middle towards the superior pole of the spleen.…”

“…DiDio et al [7] stated that the PGA supplied the superior por tion of the stomach and sometimes also the posterior wall of the abdominal esophagus, but they excluded the supply of the spleen. As already pointed out by Suzuki [26] and DiDio et al [7], an exact knowledge of the anatomy of the splenic artery and all its branches is very important for the ab dominal surgeon. Inadvertent transections may cause operative complications like heavy bleedings or focal necroses in the corresponding organs.…”

“…The PGA runs obliquely upwards and to the left and takes its course along the posterior peritoneum. The artery reaches the posterior wall of the stomach through the gastrophrenic ligamentum [26],…”

“…The designa tions used most were 'Ramus gastricus posterior', 'Arteria gastrica posterior', or a similar name in another language. Following a suggestion of Suzuki et al [26] and DiDio et al [7], the PGA was named in the Nomina Anatomica for the first time in 1980 [13]. The incidence of the PGA differs from 4% [14] up to nearly 100% [21].…”

“…This author rarely observed a branch to the superior pole of the spleen. Suzuki et al [26] described a part of the posterior gastric body near the cardia and the posterior fundus being supplied by the PGA. DiDio et al [7] stated that the PGA supplied the superior por tion of the stomach and sometimes also the posterior wall of the abdominal esophagus, but they excluded the supply of the spleen.…”