Morphological Evaluation of the Splenic Artery, Its Anatomical Variations and Irrigation Territory

Abstract

Background: Precise knowledge of the topographic features of the splenic artery and its branches in the hilum region is of practical interest due to the various interventions on the vessels of the spleen. Materials and methods: The anatomy of the spleen was studied by means of macroscopic dissection on 330 organ complexes, which were carefully documented and analyzed statistically. Results: The analysis of the splenic artery trajectory led to identification of four types: straight (43.03%), sinusoidal (27.58%), serpentine (20.91%) and alternating (8.48%). To assess the relation between the trajectory of the splenic artery and its branches we performed a chi square test. Sinuous or serpentine trajectory was associated with the presence of long splenic artery branches (dorsal pancreatic artery or the great pancreatic artery), X2 (2, N = 330) = 12.85, p = 0.001. The artery was located suprapancreatic in 70.30% of cases, anteropancreatic in 4.55%, the vessel had an intrapancreatic course in 14.85% and in 10.00% of cases the artery was located retropancreatic. The presence of inferior polar arteries was associated with a longer pancreas (Spearman’s correlation; r = 0.37; p = 0.037). In a multiple regression analysis, inferior polar arteries predicted the length of the pancreas although only a small number of cases could be explained by this model (R2 = 0.127, Adjusted R2 = 0.098; Betta = 0.357; t(330) = 2.091; p = 0.045). There were 30 (9.09%) cases of accessory spleens. Conclusions: The arterial supply of the spleen is highly variable in its trajectory, terminal branches, and relation to other organs. The splenic artery tends to be sinuous or serpentine in zones when a large artery branches off (e.g., the dorsal pancreatic or greater pancreatic artery). Multiple short branches tend to stabilize the trajectory of the splenic artery. Inferior polar arteries and accessory spleens contribute to the length of the pancreas, most likely due to increased vascular supply to the tail of the gland.

Atypically Taut Superior Polar Splenic Artery Discovered in a Human Cadaver

“…The splenic artery can be classified based on its presentation in five categories: 1) variations in its origin, 2) variations in the complexity of its path, 3) variations in its location relative to the pancreas, 4) variations in the number of terminal branches and the associated pattern of that branching, and 5) the presence or absence of polar arteries [ 4 ]. Classifying the splenic artery based on these five categories can guide gastrointestinal surgeons in their approach to procedures and help them make the necessary adjustments to ensure successful operative outcomes.…”

“…The splenic artery can also be categorized based on its trajectory from its point of origin towards the splenic hilum, with three variations of increasing complexity: straight, tortuous, or serpentine [ 4 ]. Covantsev et al examined 330 human cadaveric specimens and found that the straight path was the most common, observed in 43.03% of cases [ 4 ]. The tortuous path, described as a sinusoidal route towards the splenic hilum, was observed in 27.58% of cases [ 4 ].…”

“…Covantsev et al examined 330 human cadaveric specimens and found that the straight path was the most common, observed in 43.03% of cases [ 4 ]. The tortuous path, described as a sinusoidal route towards the splenic hilum, was observed in 27.58% of cases [ 4 ]. Finally, the serpentine path, described as extensive looping of the splenic artery, was observed in 20.91% of cases [ 4 ].…”

“…However, unexpected anatomical variations of the splenic artery can lead to surgical complications, prolonged operative time, and severe blood loss [ 3 ]. The splenic artery is the largest branch of the celiac trunk and frequently presents with variations in origin, trajectory, location relative to the pancreas, and terminal branching pattern [ 4 ]. Accessory arteries may also be present, extending from the splenic artery towards the superior and/or inferior poles of the spleen.…”

“…Accessory arteries may also be present, extending from the splenic artery towards the superior and/or inferior poles of the spleen. They are called superior polar and inferior polar arteries, respectively [ 4 ]. An understanding of such potential splenic artery variations can guide surgeons during the planning of splenectomies and other gastrointestinal surgeries to reduce the risk of iatrogenic injuries or complications [ 3 , 5 ].…”