Type of Article: Original Research
Year: 2016 | Volume 4 | Issue 3 | Page No. 2701-2705
Date of Publication: 31-08-2016
DOI: http://dx.doi.org/10.16965/ijar.2016.311
A STUDY OF COMMON COELIOMESENTERIC TRUNK WITH VARIATIONS IN THE EXTRA HEPATIC ARTERIAL SYSTEM AND ITS CLINICAL SIGNIFICANCE
P.S.Chitra *, S.Kalaiyarasi.
* Associate Professor of Anatomy, KAPV Government Medical College, Tiruchirappalli, Tamilnadu. India.
Address: Dr. P.S. Chitra.M.S. (Anatomy), Associate Professor of Anatomy, KAPV Government Medical College, Tiruchirappalli. Tamilnadu. India. Mobile No: 83447 67640. E-Mail: pschitraezhilko@gmail.com
ABSTRACT
Background: Variations in coeliac axis, superior mesenteric artery (SMA) and different mode of origin of hepatic arteries can be advantageous in some, while in some it can lead to life threatening complications. A replaced(in the absence of original artery) or an accessory (in addition to original artery) left hepatic artery provides a source of collateral arterial circulation in cases of occlusion of the vessels in the porta hepatis but may be injured during the mobilization of the stomach as it lies in the upper portion of the lesser omentum. The presence of replaced arteries can be lifesaving in patients with bile duct cancer, because they are further away from the bile duct. The study of various origin of replaced and accessory hepatic artery is more important in right lobe donation for live donor liver transplantation. It is also important in planning whole and split liver transplantation.
Materials and Methods: The common coeliomesenteric trunk (CCMT) and its branches were studied during routine dissection for the undergraduate students in 55 formalin preserved cadavers over a period of 5 years.
Results: We found common origin of coeliac axis and superior mesenteric artery (CCMT) from the anterior surface of the abdominal aorta in three cadavers. In the first cadaver, the coeliac and superior mesenteric arteries had a common origin (CCMT). In the second cadaver along with the CCMT, there was an accessory left hepatic artery, which arose from the left gastric artery to enter the left lobe of the liver. In the third cadaver along with CCMT and an accessory left hepatic artery arising from the left gastric artery which entered the left lobe of the liver, the common hepatic artery arose from superior mesenteric artery.
Conclusion: The variant anatomy of coeliac axis and superior mesenteric artery is of immense clinical significance. In case of CCMT, acute or chronic mesenteric ischemia may be observed without clinical symptoms. Accurate knowledge of all hepatic arterial system is of utmost importance in cases of recent techniques of liver transplantation like split liver or living donor transplantation and several other procedures like cholecystectomy, pancreatectomy and gastrectomy.
KEY WORDS: Coeliac axis, Superior Mesenteric artery, Common Coeliomesenteric trunk, Accessory left hepatic artery, Common hepatic artery, variations.
REFERENCES
- Susan Standring. Gray’s Anatomy 40th edi. Churchill Livingstone,2008; 1073.
- Tandler J.Uber die Varietaten der Arteia coeliaca and deren Entwicklung. Ana Hefte.1904;25(2):473-500.
- Kadir S. Atlas of normal and variant angiographic anatomy. Philadelphia:Pa:Saunders; 1991.pp.297-364.
- Sridhar Varma K, Narendra Pamidi, Venkata R. Vollala. Common Celiomesenteric trunk; a rare anatomic variation.J vasa Bras.2009;8:217-73.
- Mehmet Tugrul Yilmaz, Murat Tezer, Aynur Emine Cicekcibasi et al. A case report of coeliacomesenteric trunk. Biomedical Research 2013;24(I):150-152.
- Mange Manyama, Anthony Lukanima and Ainoli Gesase. A case of celiacomesenteric trunk in a Tanzanian man; Biomed Central Research Notes.2013; 6:341.
- Arun S Karmalkar, Priya S Patil, Anand J Poti, Vasudha R Nikam et al. Anatomical variation and Clinical implications of Celiac Trunk and Superior Mesenteric Arteries;IJARS.2014 ;Vol-3:7-10.
- Michel Nonent, Pascal Larroche,Pierre Forlodou, Bernard Senecail. Celiac- Bimesenteric trunk: Anatomic and Radiologic description-Case Report. Radiology. 2001;220(2):489-91.
- Nilgun Isiksalan Ozbulbul.CT angiography of Celiac trunk: anatomy, variants and pathologic findings.Diagn Interv Radiol.2011;17:150-57.
- Mammano E, Cosci M et al. Celiomesenteric trunk aneurysm; Ann Vasc Surg.2009 Mar;23(2):257.e7-10.
- GodlewskiG, Hedon B, Castel C. Contribution a l'etude de l'origine del'artere hepatique chez l'embryon et le foetus. Bull Assoc Anat Nancy.1975; 59: 411-418.
- Michels NA. Variational anatomy of the hepatic,cystic, and retroduodenal arteries; a statistical analysis of their origin,distribution and relations to the biliary ducts in two hundred bodies.AMA Arch Surg.1953;66(1):20-34.
- Susan Standring. Gray’s Anatomy 40th edi. Churhill. Livingstone, 2008;1169.
- R.M.Jones & K.J.Hardy et al. Hepatic Artery Anatomy In Relation To Reconstruction To Liver Transplantation Some Unusual Variations. Aust Nz.J Surg.1994;64:437-403.
- Okano S, Sawai K, Taniguchi H, Takahashi T. Aberrant left hepatic artery arising from the left gastric artery and liver function after radical gastrectomy for gastric cancer. World J sug.1993;17(1):70-3
- Glauser, F. Studies on intrahepatic arterial circulation.Surgery 1953;33:333- 334.
- Lurie AS. The Significance Of The Variant Left Accessory Hepatic Artery In Surgery for Proximal Gastric Cancer.Arch Surg. 1987;122(6):725-728.
- Rafael Lopez-Andujar, Angel Moya, Eva Montalva Marina Berenguer et al. Lessons Learned From Anatomic Variants of theHepatic Artery in 1,081 Transplanted livers. Liver Transplantation. 2007;13(10):1401-1404.
- Daseler EH,Anson BJ, Hambley WC, Reimann AF.The cystic artery and Constituent of the hepatic pedicle;A study of 500 specimens.Surg Gynecol Obstet.1947;85(1):47-63.
- Arnold MM, Kreel L, Lo YF, Law H. Are the hepatic arteries end arteries? Invest Radiol 1991;26:337-342.
P.S.Chitra, S.Kalaiyarasi. A STUDY OF COMMON COELIOMESENTERIC TRUNK WITH VARIATIONS IN THE EXTRA HEPATIC ARTERIAL SYSTEM AND ITS CLINICAL SIGNIFICANCE. Int J Anat Res 2016;4(3):2701-2705. DOI: 10.16965/ijar.2016.311
