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      A rare anastomosis between the common hepatic artery and the superior mesenteric artery: a case report

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          Abstract

          For decades, anastomoses between unpaired branches of the abdominal aorta have attracted the attention of anatomists, surgeons and radiologists, due to their significance in many clinical procedures. This report presents a rare anastomosis between the common hepatic artery and the superior mesenteric artery, which gave off three branches to the jejunum. The diameter of the anastomosis measured at the point of its branching off the common hepatic artery and at the level of union with the superior mesenteric artery was 4.46 and 4.19 mm, respectively. Moreover, the anastomosis gave off the branch to the head of the pancreas. Both embryological background and potential clinical implications of this variation are discussed. Knowledge of these vascular connections may be important for diagnostic and surgical procedures.

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          Most cited references38

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          Acute mesenteric ischemia: a clinical review.

          Acute mesenteric ischemia is a life-threatening vascular emergency that requires early diagnosis and intervention to adequately restore mesenteric blood flow and to prevent bowel necrosis and patient death. The underlying cause is varied, and the prognosis depends on the precise pathologic findings. Despite the progress in understanding the pathogenesis of mesenteric ischemia and the development of modern treatment modalities, acute mesenteric ischemia remains a diagnostic challenge for clinicians, and the delay in diagnosis contributes to the continued high mortality rate. Early diagnosis and prompt effective treatment are essential to improve the clinical outcome.
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            Celiac axis and common hepatic artery variations in 5002 patients: systematic analysis with spiral CT and DSA.

            To identify and evaluate the spectrum and prevalence of celiac axis (CA) and common hepatic artery (CHA) variations by using spiral computed tomography (CT) and digital subtraction angiography (DSA). Institutional review board approval was obtained, and the requirement for informed patient consent was waived. The findings in 5002 patients who underwent spiral CT and DSA were retrospectively evaluated. CHA was defined as an arterial trunk containing at least one segmental hepatic artery and the gastroduodenal artery. The pattern of the aortic origin of the branches of the CA and superior mesenteric arteries was analyzed. The CHA anatomy was then investigated. Of 15 possible types of CA variation, 13 types were identified. A normal CA was noted in 4457 (89.1%) of the 5002 patients. Twelve types of CA variation were identified in 482 (9.64%) patients. In the remaining 63 (1.26%) patients, the CA anatomy was classified as ambiguous because the CHA was absent owing to separate origins of the hepatic arteries and the gastroduodenal artery (n = 55) or because the origin of the CHA could not be determined owing to persistent anastomotic channels (n = 8). Seven CHAs originating from the normal CA had a retroportal (n = 6) or transpancreatic (n = 1) course. All eight CHAs originating from the left gastric artery passed the fissure of the ligamentum venosum. The 148 CHAs originating from the superior mesenteric artery showed diverse relationships with the pancreas--being supra-, trans-, or infrapancreatic--and the superior mesenteric-portal venous axis--being pre- or retroportal. The 20 CHAs originating from the aorta had a normal suprapancreatic preportal course. Known or newly found CA and CHA variations could be systematically described in detail. The authors propose a hypothetical anatomic model for summarizing the observed CHA variations. RSNA, 2010
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              A COMPOSITE STUDY OF THE COELIAC AXIS ARTERY.

              B Lipshutz (1917)
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                Author and article information

                Contributors
                (042) 6304949 , lukasz.olewnik@umed.lodz.pl
                Journal
                Surg Radiol Anat
                Surg Radiol Anat
                Surgical and Radiologic Anatomy
                Springer Paris (Paris )
                0930-1038
                1279-8517
                21 April 2017
                21 April 2017
                2017
                : 39
                : 10
                : 1175-1179
                Affiliations
                [1 ]ISNI 0000 0001 2165 3025, GRID grid.8267.b, Department of Normal and Clinical Anatomy, Interfaculty Chair of Anatomy and Histology, , Medical University of Lodz, ; ul. Narutowicza 60, 90-136 Lodz, Poland
                [2 ]ISNI 0000 0001 2165 3025, GRID grid.8267.b, Department of Angiology, , Medical University of Lodz, ; Lodz, Poland
                Article
                1859
                10.1007/s00276-017-1859-2
                5610665
                28432408
                7baa8fae-6291-42ab-a18c-ddd578cdc605
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 16 January 2017
                : 14 April 2017
                Categories
                Anatomic Variations
                Custom metadata
                © Springer-Verlag France SAS 2017

                Surgery
                anastomosis,common hepatic artery,superior mesenteric artery
                Surgery
                anastomosis, common hepatic artery, superior mesenteric artery

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