Replaced right hepatic artery and its segmental distribution

Abstract

A case of replaced right hepatic artery arising from the superior mesenteric artery is presented with its segmental distribution and the morphometric features. The case was encountered in a 66-year-old formalin-fixed male cadaver during dissection for undergraduate lab education. Length and diameter of the replaced right hepatic artery were measured 63.10 mm and 3.6 mm, respectively. The replaced right hepatic artery coursed posterior to the portal vein initially, and then lateral to it. One of its branches entered into liver segments V and VIII, and the other entered into segments VI and VII. Left hepatic artery arose from the common hepatic artery and gave the middle hepatic artery 11.9 mm distal to its origin. Length and diameter of the middle hepatic artery were measured 30.2 mm and 1.2 mm, respectively. After giving a small branch to caudate lobe, the middle hepatic artery reached the quadrate lobe. The diameter and segmental distribution of replaced right hepatic artery was similar to the normal right hepatic artery described in earlier studies. The middle hepatic artery arose from the left hepatic artery at a substantial distance from the liver tissue in the presence of a replaced right hepatic artery. This is of clinical significance in liver transplantations as the arterial supply of segment IV is from the middle segmental artery.

Unusual arterial supply of the segment IV with interlobar bridge and right replaced hepatic artery: a case report

“…In the literature, hepatic arteries have many variations in terms of their origins. Two main classifications have been described so far: replaced [2,4,6,12,16] and accessory hepatic arteries [11,12,16]. The accessory hepatic artery is present in addition to the main artery of the right and/or left lobes [2,16] while the replaced hepatic artery originates from another artery instead of the proper hepatic artery (usually from the superior mesenteric artery or the coeliac trunk) [2,12,16].…”