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

Abstract

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.

Anatomical Variations of Celiac Trunk Branching Pattern in Different Ethnic Groups in Population of Karachi by 3D MDCTA

“…Celiac mesenteric trunk (typeVI) was also observed in north Indian population with the frequency of 0.91% individual. This type of variation was also found in our study participants in Urdu speaking individual with the frequency of 0.625% individual (26) . Though in our study Type IV and type VI was only found in Urdu speaking individuals.…”

“…Frequency of hepatogastric trunk in Turkish population was reported to be 1% (16) while in Brazalians it was reported to be 1.7% i.e 1 individual each (30) . A study conducted on north Indian population published in 2021 showed Hepatogastric trunk with the frequency of 1.82% cases (26) while in south Indian population hepatogastric trunk was not present (27). Present study showed hepatogastric trunk was only present in Pathan speaking.…”

“…A study published in 2021 on north Indian population which showed type V was 2 nd most frequent variation found in their study participants i.e. 4.55 % individuals (26). Another study conducted on south Indian population showed type V was found to be 2 nd most frequent variation with frequency of 1.5% (27) .…”

“…02, February, 2023 201 are number of studies conducted on different Indian population on celiac trunk branching patterns. A recent study conducted on north Indian population which depicts celiac trunk variations with the frequency of 69.09% and the most frequent variation was found to be (type II ) hepatosplenic trunk with the frequency of 60 % (24) . In present study type II was also found to be the most frequent variations of celiac trunk branching pattern i.e.…”

Development of a Novel Scoring Model to Estimate the Severity Grade of Mesenteric Artery Stenosis

“…However, this procedure is technically challenging and requires expertise in ultrasound imaging, visceral arterial hemodynamics, and duplex scan interpretation. On the other hand, CTA with 2D and 3D imaging can provide excellent reconstructions of the visceral arteries and is recommended as the initial imaging study in many studies [4,[27][28][29][30][31][32][33][34][35][36][37]. Furthermore, centerline analysis may be helpful in increasing the accuracy of the measurement of the stenosis and is especially appropriate for preoperative planning of endovascular treatment.…”