Ring-shaped variation of the coeliac trunk branches

Abstract

Aberrant arterial variations in the branching pattern of the coeliac trunk are of great interest to surgeons and radiologists. We report on a rare arterial variation found in a 79-year-old cadaver during educational dissection. Specifically, the coeliac axis formed a unique incomplete trunk termed the hepato-hepatic trunk. The splenic artery arose separately from the anterior aspect of the abdominal aorta. On the right side, there was a right hepatic artery giving rise to a gastroduodenal but an absence of the left hepatic. On the left side, there was a branch coursing towards the porta hepatis; the left hepatic artery, dividing into the left gastric, an accessory left gastric, and a branch to the distal oesophagus. The hepato-hepatic trunk formed a ring-shaped vascular structure around the caudate lobe of the liver. Precise mapping and observation of the extrahepatic arteries and bile duct branches is essential in a variety of hepato-biliary laparoscopic procedures of the liver and gallbladder. Other operative procedures requiring, a comprehensive knowledge of the varied coeliac trunk patterns are liver transplantation and arterial embolism for hepatic tumour therapy.