Variations in the Arterial Branching Pattern of the Coeliac Trunk : A Cadaveric Study

Abstract

ABSTRACT:The knowledge of the anomalous arterial branching patterns is essential from the view point of surgical anatomy, especially while contemplating hepatic and pancreatic surgeries. The anatomical variations of the celiac trunk, superior mesenteric artery, renal and gonadal arteries are well established. The presence of anomalous origin of the inferior phrenic artery from the celiac trunk is comparatively rare in available literature but is clinically very important because this may act as a major source of collateral or parasitized arterial supply to hepato-cellular carcinoma, second only to the hepatic artery. The present study was carried out from the data collected over a period of four years when routine dissection was done while teaching the first year MBBS undergraduate students. The arterial branching pattern of the coeliaco-mesenteric axis was noted down from a total of 40 cadavers (10 each year) and any anomalous pattern observed was documented. In our study we observed a lower origin of the celiac trunk through the substance of the pancreas in 3 cases, presence of two separate trunks namely gastro-splenic and hepato-mesenteric arising from the abdominal aorta in 4 cases and both inferior phrenic arteries arising from celiac trunk in 1 case. The remaining 32 cadavers had normal arterial branching pattern. These anomalies could cause a catastrophe during surgical procedures, especially laparoscopic ones if the same is not kept in mind before contemplating pre-operative investigations. The awareness of these vascular anomalies is very important while contemplating radiological and surgical interventions. Therefore keeping in mind the immense radiological and surgical importance of these variations, the continuous reporting of such cases is significant.