IJAR.2023.155
Type of Article: Case Report
Volume 11; Issue 3 (September 2023)
Page No.: 8659-8662
DOI: https://dx.doi.org/10.16965/ijar.2023.155
Missing common Hepatic Artery and variant Right Hepatic Artery – An incidental finding on CT imaging
Nikhil Aggarwal 1, Garima Sehgal 2, Kaweri Dande *3, Punita Manik 4.
1 Senior Resident, Department of Anatomy, King George’s Medical University, Lucknow, Uttar Pradesh, India. ORCiD: 0000-0002-4653-7060
2 Professor Jr. Grade, Department of Anatomy, King George’s Medical University, Lucknow, Uttar Pradesh, India. ORCiD: 0000-0002-4987-5487
*3 Senior Resident, Department of Anatomy, King George’s Medical University, Lucknow, Uttar Pradesh, India. ORCiD: 0000-0003-0450-3484
4 Professor and Head, Department of Anatomy, King George’s Medical University, Lucknow, Uttar Pradesh, India. ORCiD: 0000-0001-9942-250X
Corresponding Author: Dr. Kaweri Dande, Senior Resident, Department of Anatomy, King George’s Medical University, Lucknow, Uttar Pradesh, India. E-Mail: kdande03@gmail.com
ABSTRACT
During abdominal surgery, the blood supply to the liver and other abdominal organs plays a vital role. The knowledge regarding hepatic artery variations is crucial for various surgical and radiological procedures concerning the liver and dutiful to be reported. We aim to report a case of variant origin of the right hepatic artery to contribute to the existing knowledge pool to improve surgical safety. The present case describes a variant hepatic vascularization encountered on 3D volume-rendered CT imaging of a 60-year-old male admitted to the hospital emergency for recurrent abdominal pain. The common hepatic artery was absent. The right hepatic artery was observed to arise from the superior mesenteric artery, while the left hepatic artery arose directly from the coeliac artery. Awareness of such abnormalities is critical to minimize morbidity and prevent operational complications in hepatic surgery or liver transplantation.
Key words: hepatic artery, CT scan, variations, anatomy, superior mesenteric artery, liver.
REFERENCES
[1]. Sridhar P, Vasanti A, Vaishaly B. Variations in origin and branching pattern of hepatic arteries and their clinical significance. Eur. J. Anat. 2019;23(4):279-87.
[2]. Standring S. Gray’s anatomy. 42nd edition. Churchill Livingstone: Elsevier. 2021;1211-1212.
[3]. Abdullah SS, Mabrut JY, Garbit V, et al. Anatomical variations of the hepatic artery: study of 932 cases in liver transplantation. Surg Radiol Anat. 2006;28:468-73.
[4]. Covey AM, Brody LA, Maluccio MA, Getrajdman GI, Brown KT. Variant hepatic arterial anatomy revisited: digital subtraction angiography performed in 600 patients. Radiology.2002;224:542-7.
[5]. De Santis M, Ariosi P, Calo GF, Romagnoli R. Hepatic arterial vascular anatomy and its variants. Radiol Med (Torino).2000;100:145-51.
[6]. Gruttadauria S, Foglieni CS, Doria C, Luca A, Lauro A, Marino IR. The hepatic artery in liver transplantation and surgery: vascular anomalies in 701 cases. Clin Transplant.2001;15:359-63.
[7]. Jones RM, Hardy KJ. The hepatic artery: a reminder of surgical anatomy. J R Coll Surg Edinb.2001;46:168-70.
[8]. Peschaud F, El Hajjam M, Malafosse R, et al. A common hepatic artery passing in front of the portal vein. Surg Radiol Anat.2006;28:202-5.
[9]. Volpe CM, Peterson S, Hoover EL, Doerr RJ. Justification for visceral angiography prior to pancreaticoduodenectomy. Am Surg.1998;64:758-61.
[10]. Michels NA. Newer anatomy of the liver and its variant blood supply and collateral circulation. Am J Surg. 1966;112:337–47.
[11]. Hiatt JR, Gabbay J, Busuttil RW. Surgical anatomy of the hepatic arteries in 1000 cases. Ann Surg. 1994;220:50–2.
[12]. Ugurel MS, Battal B, Bozlar U, Nural MS, Tasar M, Ors F, Saglam M, Karademir I. Anatomical variations of hepatic arterial system, coeliac trunk and renal arteries: an analysis with multidetector CT angiography. Br J Radiol.2010;83(992):661-7.
[13]. Michels NA. Blood supply and anatomy of the upper abdominal organs. Philadelphia: JB Lippincott. 1955.
[14]. Arnold MM, Kreel L, Lo YF, Law H. Are the hepatic arteries “end arteries”? Invest Radiol.1991;26:337-42.
[15]. Weiglein AH. Variations and topography of the arteries in the lesser omentum in humans. Clin Anat.1996;9:143-50.
[16]. Choi TW, Chung JW, Kim HC, Lee M, Choi JW, Jae HJ, et al. Anatomic Variations of the Hepatic Artery in 5625 Patients. Cardiothoracic Imaging. 2021;3(4).
[17]. Sukumaran TT, Joseph S, Ramakrishnan S, Mathew AJ. Anatomical variations of the hepatic artery in its extrahepatic journey: a cadaveric study with its clinical implications. Anat Cell Biol. 2022 Sep 30;55(3):269-276.
[18]. Moon JJ, Widjicks CA, Williams JM. Right hepatic artery branching off the superior mesenteric artery and its potential implications. IJAV. 2009;2:143–5.
