Common hepatic artery branching from the superior mesenteric artery with a common trunk of the inferior pancreaticoduodenal artery and first jejunal artery.

Adachi type VI is a rare celiac artery (CA) variant in which the left gastric and splenic arteries form a gastrosplenic trunk. In this type, the common hepatic artery (CHA) and superior mesenteric artery (SMA) arise from a hepatomesenteric trunk, and the CHA passes posterior to the portal vein (PV). In addition, a common trunk formed by the inferior pancreaticoduodenal artery (IPDA) and the first jejunal artery (J1A) has been reported in anatomical studies. However, to our knowledge, the concurrent presence of Adachi type VI together with a posteriorly originating IPDA-J1A common trunk has not been previously reported. A 93-year-old male cadaver donated to Tokyo Medical University was examined. The arterial system of the upper abdomen was observed macroscopically, and arterial diameters and branching patterns were recorded. A gastrosplenic trunk arose from the abdominal aorta (AA) and divided into the left gastric artery (LGA) and splenic artery (SA). Inferior to the gastrosplenic trunk, a hepatomesenteric trunk arose from the AA and divided into the CHA and SMA, corresponding to Adachi type VI. In addition, the IPDA and J1A arose from a common trunk originating from the posterior aspect of the SMA. The coexistence of these variations could reflect the persistence of ventral splanchnic arterial segments that normally regress during embryonic development. Clinically, procedures such as Appleby's operation and distal pancreatectomy with CA resection can compromise hepatic and gastric perfusion, although collateral pathways from the SMA may compensate in some cases. Therefore, understanding arterial variations such as the present case is important from both anatomical and clinical perspectives.