Surgical and radiological significance of variants of Bühler’s anastomotic artery a report of three cases

Abstract

Arterial anastomoses between the celiac trunk (CT) and superior mesenteric artery (SMA) include three variants. 1) The main anastomosis is the gastroduodenal artery (GDA), which is an important branch of the common hepatic artery and anastomoses with branches of the inferior pancreatic duodenal artery, a branch of the SMA. 2) The dorsal pancreatic artery (DPA) is usually a branch of the splenic artery, which anastomoses with the anterior and posterior pancreaticoduodenal arcades via a right transverse branch of the DPA (Kirk's arcade). 3) A less well known and rarely reported arterial anastomosis between the CT and SMA described by Buhler (1904). Three patients in whom variants of this anastomosis were present on retrospective analysis of three hundred consecutive combined CT and SMA arteriograms are reported. The embryological basis of its development, the surgical and radiological significance of the anastomotic artery are discussed.

Prevalence-of-Anatomical-Celiac-Trunk-Variations-Using-3D-AngiographyComputed-Tomography-Images-in-a-Reference-Hospital

“…Also the presence of Accessory arteries to the liver and pancreas ( Figure 2B) was found in the same proportion as reported in other studies between 3-10% [28,29]. This variation has been related to pancreatic ischemia secondary to clipping accessories arteries to the pancreas erroneously during abdominal surgeries, liver necrosis during liver transplantation, and during pancreatoduodenectomy and laparoscopic operations of the biliary tract [30][31][32][33][34][35][36][37].…”

Anatomical variations of the coeliac trunk in the homogeneous Polish population

“…The common origin of the coeliac trunk and the SMA is known by arc of Bühler's [17] and was identified in 3.3% by Saad et al [24] and in 14 cases of 340 arteriograms (4.1%) by Grabbe et al [8]. However, there is also a report of no coeliac-mesenteric trunk when examining 100 cases [35].…”

A case of celiacomesenteric trunk in a Tanzanian man

“…Most of the other metameric arteries and the Tandler’s anterior longitudinal anastomosis which connects them regress during the evolution of the embryo [11]. In some cases, the persistence of the anterior anastomosis or regression of one of the primitive arteries that form the CA, SMA and IMA may explain some of the variations observed in the adult [12]. Embryologically therefore, the occurrence of celiacomesenteric trunk can be explained by regression of the 10th root and persistence of both the 13th root and the anterior anastomosis.…”