The left inferior phrenic artery arising from left hepatic artery or left gastric artery: radiological and anatomical correlation in clinical cases and cadaver dissection (original) (raw)
Related papers
Right accessory hepatic artery arising from the left gastric artery: a case report
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2011
During educational dissection of the abdomen in a female Caucasian cadaver, an unusual origin of an accessory right hepatic artery from the left gastric artery was observed. The left gastric artery was the first branch of the celiac trunk, but ended trifurcating into two abnormal large gastric branches and an accessory hepatic artery (d=1.27 cm) which entered the right hepatic lobe at the margin between the two lobes and close to the quadrate lobe. An aberrant hepatic artery branching from the left gastric supplies the left lobe of the liver in most of the cases. The irrigation of the right lobe described by us seems to be extremely rare. Nevertheless, this arterial anomaly can be enlightened by embryonic development. The knowledge of existence of aberrant hepatic arteries, either accessory or replacing, is important because they may influence surgical and interventional radiological procedures.
2013
Variations in the origin and branches of the celiac trunk are well established. We are reporting a rare case of celiac trunk with two main branches, hepato-splenic trunk and gastro-phrenic trunk in the place of the three classic branches. Hepato-splenic trunk divided into common hepatic artery and splenic artery. Gastro-phrenic trunk divided into left gastric artery, left inferior phrenic artery and right inferior phrenic artery. Anatomical variations in the branching pattern of the celiac trunk are of considerable importance in liver transplants, laparoscopic surgery, radiological abdominal interventions and penetrating injuries to the abdomen.
Clinical anatomy of the inferior phrenic artery
Clinical Anatomy, 2005
The majority of anatomical textbooks of gross anatomy offer very little information concerning the anatomy and distribution of the inferior phrenic artery (IPA). In the last decade, however, increased numbers of reports have appeared with reference to the arterial supply of hepatocellular carcinoma (HCC). The IPA is a major source of collateral or parasitized arterial supply to this type of carcinoma, second only to the hepatic artery. The aim of this study was to identify the origin and distribution of the IPA (right and left), in normal and pathological cases, and to apply such findings to the clinical scenario of treating hepatic cancer. We have examined 300 formalin-fixed adult cadavers lacking abdominal pathology, and 30 cadavers derived from patients with HCC. Dissections in normal cadavers showed that the right IPA originated from the: a) celiac trunk in 40% of the specimens; b) aorta in 38%; c) renal in 17%; d) left gastric in 3%; and e) hepatic artery proper in 2% of the specimens. The left IPA originated from the: a) celiac trunk in 47%; b) aorta in 45%; c) renal in 5%; d) left gastric in 2%; and e) hepatic artery proper in 1% of the specimens. The IPA gave rise to eight notable branches: ascending, descending, inferior vena cava, superior suprarenal, middle suprarenal, esophageal, diaphragmatic hiatal, and accessory splenic. The right IPA was always associated with HCC and served as the major collateral artery adjunct to the hepatic artery. These findings could have major implications in the transcatheter embolization of HCC patients. Clin. Anat. 18:357-365, 2005. V V C 2005 Wiley-Liss, Inc.
Missing common Hepatic Artery and variant Right Hepatic Artery - An incidental finding on CT imaging
International Journal of Anatomy and Research
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, s...
Left gastric artery variants: A cadaveric, postmortem and radiological investigation
Scripta medica, 2023
Background/Aim: Anatomical variations of the gastric vessels during laparoscopic surgeries of the stomach and related viscera frequently impair the surgeon's judgment, extend the duration of surgery and sometimes can lead to accidental surgical injuries, rendering it not possible to assure the safety and effectiveness of the surgical treatment. This research paper aimed to examine the variations of the left gastric artery (LGA), which could have implications for surgical and interventional procedures of the gastrointestinal tract (GIT) and related organs. Methods: Fifty specimens, of which 22 were dissected from cadavers and 28 were acquired from post-mortems among the Indian population, regardless of age or sex were examined for variant LGA. In addition, the variation of the celiac trunk was observed in 10 patients using 3D-CT images, which were created by reconstructing multiple-slice computed tomography (CT) using 3-dimensional CT simulation software (3D-CT). Results: The classical pattern origin of LGA from the celiac trunk was observed in 96 % specimens. In 2 % gastrophrenic trunk emerged from the abdominal aorta (AA) slightly proximal to the celiac trunk, then it branched into LGA and left and right inferior phrenic arteries. In remaining 2 %, LGA was the branch of the splenic artery. In 10 individuals radiological examination was conducted and found no abnormal pattern of celiac trunk. Conclusion: Observing and reporting the variation in the gastric vessels by different methods has certain clinical value in upper gastrointestinal surgeries and interventions. The duration can be prolonged and the intraoperative blood loss is increased with the vascular variations. Overall, this research paper provides important information on the prevalence of anatomical variations of the LGA, which could help improve the safety and efficacy of upper gastrointestinal procedures.
2014
INTRODUCTION: IPA usually originates from aorta as a first lateral branch just above the celiac trunk to supply mainly to the suprarenal gland and the diaphragm. Besides this left IPA may give rise to a small number of branches that serve to supply the superior pole of the spleen and the proximal portion of the stomach. [1] The right IPA potentially communicates with the intra-hepatic arteries and one of the most common sources of extra blood supply to liver as collateral pathways.[2,3] IPA usually develops from lateral splanchnic branch of dorsal aorta. The IPA bud out from the highest suprarenal artery and the permanent renal artery sprouts from the lowest suprarenal artery.[4] The roentgenographic anatomy of phrenic arteries has been described in detail by Kahn et al.[5] Variation of the IPA and their relations to the surrounding structures are important in regard to intra-abdominal surgeries. Ligation or damage to these arteries without knowing the variations during surgical app...
Surgical and Radiologic Anatomy, 2006
Anatomical variations of the arterial supply of the liver are not uncommon. The typical normal "textbook" anatomy of the hepatic artery is found only in approximately half of the cases. Some of the variations such as the presence of a right or left hepatic branch are more common, but other ones are extremely rare. We describe here a rare case in which the common hepatic artery arose from the left gastric artery, found during a cadaveric liver donor harvesting and conWrmed with imaging studies. Cases like this one highlight the importance of knowing the hepatic arterial anatomy and the possibility of its numerous variations by the transplant and hepatobiliary surgeon.
Right Hepatic Artery: A Cadaver Investigation and Its Clinical Significance
Anatomy Research International, 2015
The right hepatic artery is an end artery and contributes sole arterial supply to right lobe of the liver. Misinterpretation of normal anatomy and anatomical variations of the right hepatic artery contribute to the major intraoperative mishaps and complications in hepatobiliary surgery. The frequency of inadvertent or iatrogenic hepatobiliary vascular injury rises with the event of an aberrant anatomy. This descriptive study was carried out to document the normal anatomy and different variations of right hepatic artery to contribute to existing knowledge of right hepatic artery to improve surgical safety. This study conducted on 60 cadavers revealed aberrant replaced right hepatic artery in 18.3% and aberrant accessory right hepatic artery in 3.4%. Considering the course, the right hepatic artery ran outside Calot’s triangle in 5% of cases and caterpillar hump right hepatic artery was seen in 13.3% of cases. The right hepatic artery (normal and aberrant) crossed anteriorly to the co...
An anomalous right gastroepiploic artery arising from the superior mesenteric artery
Surgical and Radiologic Anatomy, 1999
During a routine dissection, the right gastroepiploic artery was found to arise from the superior mesenteric artery. The gastroduodenal artery ran in front of the common bile duct and descended along the posterior surface of the head of the pancreas (posterior superior pancreaticoduodenal artery). The enlarged pancreatic branch arising from the superior mesenteric artery mainly supplied the anterior surface of the head of the pancreas and then continued to become the right gastroepiploic artery. This route seemed to be formed due to the lack of a connection between the posterior superior pancreaticoduodenal artery and the common trunk of the anterior superior pancreaticoduodenal and right gastroepiploic arteries. Une art~re gastro-dpiplo'/que droite anormale naissante de l'art~re m6sen-t6rique sup6rieure Rfisum6 : Au cours d'une dissection, nous avons retrouv6 une art6re gastro-6piplo'/que droite naissant de l'art6re m6sent6rique sup6rieure. L'artbre gastro-Correspondence to: H. Sakamoto duoddnale croisait en avant le conduit chol6doque et descendait le long de ta face postdrieure de la t~te du pancr6as (artbre pancr6atico-duod6nale postdrieure et supdrieure). Une grosse branche pan-cr6atique naissant de l'art~re mdsentdrique supdrieure vascularisait principalement la face ant6rieure de la t~te du pan-cr6as, puis continuait son trajet pour devenir l'art~re gastro-dpiplo~'que droite. Cette situation pourrait ~tre due au manque de connexion entre l'art~re pancrdatico-duoddnale postdrieure et antdrieure d'une part, le tronc des attires pan-crEatico-duoddnales antdrieure et sup& rieure et de l'artbre gastro-6piplo~'que droite, d'autre part.
The importance of an Aberrant Left Hepatic Artery (ALHA), so-called Hyrtl’s artery
2020
Knowledge of anatomical variants in hepatic vascular structures is obligatory in surgical practice. The purpose of this study is to describe anatomic variations in the Left Hepatic Artery (LHA). In ~60% of cases, LHA is a branch of the proper hepatic artery. The main anatomical variant is an Aberrant Left Hepatic Artery (ALHA) which stems from the Left Gastric Artery, also known as Hyrtl's artery. The proper identifi cation of ALHA is of importance in the planning and performance of all surgical procedures in the upper abdomen.