Variations of the celiac trunk investigated by multidetector computed tomography: Systematic review and meta‐analysis with clinical correlations

Abstract

In recent years multidetector computed tomography (MDCT) has been used to investigate vascular anatomy for scientific and diagnostic purposes. These studies allow for much larger sample sizes than traditional cadaveric studies. The aim of this research was to perform a systematic review and meta-analysis on studies investigating the variations of the celiac trunk using MDCT. Major medical databases were used to find studies investigating celiac trunk anatomy using MDCT. Extracted information included demographic details, number of normal celiac trunks, and number of each variant celiac trunk. Using a random effects meta-analysis the pooled prevalence of each variation was calculated. A total of 36 studies from 14 countries and four continents were included in the meta-analysis. The total number of subjects included was 17,391. The total prevalence of variant celiac trunks was 10.85%. The different types of celiac trunk variations with their prevalences were: gastrosplenic trunk (3.46%), hepatosplenic trunk (3.88%), hepatogastric trunk (0.24%), absent celiac trunk (0.28%), celiacomesenteric trunk (0.46%), hepatosplenomesenteric trunk (0.26%), gastrosplenomesenteric trunk (0.07%), and celiacomesenteric anastomosis (0.09%). A total of 61 cases (0.19%) were either not described or not described adequately to be included in our classification. Major variations of the celiac trunk are not uncommon and should be anticipated before radiological and surgical interventions. Knowledge of celiac trunk anatomy is important in hepatopancreatobiliary surgery, transplantology, and interventional radiology.

Coeliac trunk and its anatomic variations: a cadaveric study

“…Due to high number of articles describing variations of the celiac trunk, there was a necessity to find appropiate results evaluated in one review. Santos et al and Whitley et al presented results of the previous studies about the celiac trunk and their findings were used to elaborate and compare our results with the other studies focused on the Polish population or the cadaveric studies [32,33].…”

Rare combined variations of the coeliac trunk, accessory hepatic and gastric arteries with co-occurrence of double cystic arteries

“…The majority of the used classifications do not perceive it as a trunk and in most cases it is recognised in association with presence of the hepatosplenomesenteric trunk [16,22,26,28] but the co-occurrence with the hepatosplenic trunk also was described [32,37]. According to the classification proposed by Whitley et al [35], this type of trunk is not included but we came to the conclusion that it is important to mention this fact. Inferior phrenic arteries more frequently originate asymmetrically [5].…”

“…As we mentioned, the hepatosplenic trunk was observed in 3.88% of cases with the abdominal aorta as the origin feeding of the LGA in 99.87%. More rarely the LGA arises from the SMA (0.76%) or it is absent (0.38%) [35]. The prevalence of the cases where the LGA gave off the RIPA is estimated at 2% to 4.1% [25].…”

“…Adachi (1928) [1] elaborated the classification of variations of the coeliac trunk, which is also used currently, and Michels [23] was one of the first researches who described and classified the variability of the hepatic arterial supply. According to recent reviews, the most common variation in types of the incomplete coeliac trunk was the hepatosplenic trunk present in 3.88% of cases with the left gastric artery (LGA) originating from the ab-dominal aorta in 99.87% [35]. The right gastric artery (RGA) most frequently goes from the proper hepatic artery -in 53% of cases [11].…”

Rare Anatomic Variation: The Hepatosplenomesentericophrenic Trunk

“…A true classical trifurcation occurs when all the three branches of the CT leave at the same point, while a false classical trifurcation occurs when the LGA leaves as a collateral branch, then the CT divides terminally into the SA and CHA. The normal anatomy of the CT can show a broad spectrum of anatomic variations [2,3].…”