Types of inferior phrenic arteries: a new point of view based on a cadaveric study

Szewczyk, Bartłomiej; Karauda, Piotr; Olewnik, Łukasz; Podgórski, Michał; Waśniewska, Anna; Haładaj, Robert; Rapacka, E; Oszukowski, P; Polguj, Michał

doi:10.5603/fm.a2020.0079

Cited by 8 publications

(4 citation statements)

References 30 publications

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“…The right and left inferior phrenic arteries normally arise from the aorta or celiac axis independently, or as a common trunk. However, these arteries show several variations depending upon their origin [ 35 , 36 , 37 ]. Understanding the variations of the inferior phrenic artery are important for surgical and radiological interventions in conditions such as hepatocellular carcinoma, traumatic vascular injuries, hemoptysis and gastroesophageal hemorrhage [ 35 ].…”

Section: Introductionmentioning

confidence: 99%

Unraveling Variations in Celiac Trunk and Hepatic Artery by CT Angiography to Aid in Surgeries of Upper Abdominal Region

et al. 2021

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Understanding of variations in the course and source of abdominal arteries is crucial for any surgical intervention in the peritoneal space. Intricate surgeries of the upper abdominal region, such as hepato-biliary, pancreatic, gastric and splenic surgeries, require precise knowledge of regular anatomy and different variations related to celiac trunk and hepatic artery. In addition, information about the origin of inferior phrenic artery is important in conditions such as hepatocellular carcinoma and gastroesophageal bleeding management. The present study gives an account of anatomical variations in origin and branching pattern of celiac trunk and hepatic artery by the use of CT (computed tomographic) angiography. The study was performed on 110 (66 females and 44 males) patients in a north Indian population. Results unraveled the most common celiac trunk variation as hepatosplenic trunk with left gastric artery, which was observed in 60% of cases, more common in females than in males. Gastrosplenic and hepato-gastric trunk could be seen in 4.55% and 1.82% cases respectively. Gastrosplenic trunk was more commonly found in females, whereas hepato-gastric trunk was more common in males. A gastrosplenic trunk, along with the hepato-mesenteric trunk, was observed in 1.82% cases and was more common in males. A celiacomesenteric trunk, in which the celiac trunk and superior mesenteric artery originated as a common trunk from the aorta, was seen only in 0.91% of cases, and exhibited an origin of right and left inferior phrenic artery from the left gastric artery. The most common variation of hepatic artery, in which the right hepatic artery was replaced and originated from the superior mesenteric artery, was observed in 3.64%, cases with a more common occurrence in males. In 1.82% cases, the left hepatic artery was replaced and originated from the left gastric artery, which was observed only in females. Common hepatic artery originated from the superior mesenteric artery, as observed in 1.82% cases, with slightly higher occurrence in males. These findings not only add to the existing knowledge apart from giving an overview of variations in north Indian population, but also give an account of their correlation with gender. The present study will prove to be important for various surgeries of the upper abdominal region.

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Section: Introductionmentioning

confidence: 99%

Unraveling Variations in Celiac Trunk and Hepatic Artery by CT Angiography to Aid in Surgeries of Upper Abdominal Region

et al. 2021

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“…18 In a recent investigation, the LGA is given origin to the inferior RIPA and LIPA, while no celiac trunk was found. 19 In this study, the left IPA was the branch off LGA in 4 % of individuals as existing data. The hepatosplenic trunk, gastrophrenic trunk, splenic hypoplasia and auxiliary spleen were described by Yi et al, 20 whereas Shibamoto et al reported the concurrent existence of the LGA and CHA that courses retroportally called the hepatosplenomesenteric trunk and for both IPAs a common trunk in cancer stomach patient.…”

Section: Discussionmentioning

confidence: 53%

Left gastric artery variants: A cadaveric, postmortem and radiological investigation

Ande,

Makani,

Nannam

et al. 2023

Scripta Medica

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Background/Aim: Anatomical variations of the gastric vessels during laparoscopic surgeries of the stomach and related viscera frequently impair the surgeon's judgment, extend the duration of surgery and sometimes can lead to accidental surgical injuries, rendering it not possible to assure the safety and effectiveness of the surgical treatment. This research paper aimed to examine the variations of the left gastric artery (LGA), which could have implications for surgical and interventional procedures of the gastrointestinal tract (GIT) and related organs. Methods: Fifty specimens, of which 22 were dissected from cadavers and 28 were acquired from post-mortems among the Indian population, regardless of age or sex were examined for variant LGA. In addition, the variation of the celiac trunk was observed in 10 patients using 3D-CT images, which were created by reconstructing multiple-slice computed tomography (CT) using 3-dimensional CT simulation software (3D-CT). Results: The classical pattern origin of LGA from the celiac trunk was observed in 96 % specimens. In 2 % gastrophrenic trunk emerged from the abdominal aorta (AA) slightly proximal to the celiac trunk, then it branched into LGA and left and right inferior phrenic arteries. In remaining 2 %, LGA was the branch of the splenic artery. In 10 individuals radiological examination was conducted and found no abnormal pattern of celiac trunk. Conclusion: Observing and reporting the variation in the gastric vessels by different methods has certain clinical value in upper gastrointestinal surgeries and interventions. The duration can be prolonged and the intraoperative blood loss is increased with the vascular variations. Overall, this research paper provides important information on the prevalence of anatomical variations of the LGA, which could help improve the safety and efficacy of upper gastrointestinal procedures.

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“…Classical dissection techniques were used (Balcerzak et al, 2020; Olewnik et al, 2018; Olewnik, Wysiadecki, Polguj, Waśniewska, et al, 2017; Szewczyk et al, 2020; Waśniewska et al, 2020). During the dissection, the following were observed: the morphology of the SMA, the point where it branched off the abdominal aorta in reference to the spine, the distance to the celiac trunk, the distance to the inferior mesenteric artery, and the distances to the origins of the common iliac arteries and the median sacral artery (MSA).…”

Section: Methodsmentioning

confidence: 99%

Classification of the superior mesenteric artery

Balcerzak

Tubbs

Waśniewska-Włodarczyk

et al. 2022

Clinical Anatomy

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The aim of this study was to characterize the branching pattern and morphology of the superior mesenteric artery (SMA), and also to create a new SMA classification, which seems necessary for clinicians performing surgery in this anatomical area. The anatomical variations in the branching patterns of the SMA were examined in 30 cadavers fixed in 10% formalin. Morphometric measurements were then obtained twice by two researchers. In the proposed classification system, Type I, characterized by all normal branches—inferior pancreatoduodenal artery, ileocolic artery, right colic artery, middle colic artery and intestinal arteries—occurred in 53.33% of the specimens. Type II, characterized by absence of the inferior pancreatoduodenal artery, was present in 26.67%. Type III, characterized by absence of the right colic artery, was present in 3.33%. Type IV, characterized by a common trunk for the inferior pancreatoduodenal artery and middle colic arteries, was observed in 3.33%. Type V, characterized by an aberrant hepatic artery and absence of the inferior pancreatoduodenal artery, was observed in 13.33%. The origin of the SMA was at the Th12/L1 level in 10% of cases, at L1 in 43.33%, at L1/L2 in 36.67%, and at L2 in 10%. The SMA is characterized by high morphological variability, the variants being associated with distinct clinical aspects. The introduction of a new, structured, anatomical classification seems necessary for all clinicians.

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Types of inferior phrenic arteries: a new point of view based on a cadaveric study

Cited by 8 publications

References 30 publications

Unraveling Variations in Celiac Trunk and Hepatic Artery by CT Angiography to Aid in Surgeries of Upper Abdominal Region

Unraveling Variations in Celiac Trunk and Hepatic Artery by CT Angiography to Aid in Surgeries of Upper Abdominal Region

Left gastric artery variants: A cadaveric, postmortem and radiological investigation

Classification of the superior mesenteric artery

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