ArticleSurgical and radiologic anatomy : SRA2026
Extremely long celiac trunk continuing as the splenic artery with replaced right hepatic artery originating from the superior mesenteric artery: a rare anatomical variation.
Article in Surgical and radiologic anatomy : SRA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeKnowledge of anatomical variations of the celiac trunk and hepatic arteries is crucial to prevent iatrogenic injury during endovascular interventions and hepatobiliary surgery.
methodsA diagnostic abdominal computed tomography angiography (CTA) with 3D volume rendering and multiplanar reconstructions was performed in a 65-year-old male patient investigated for hepatocellular carcinoma for whom transarterial chemoembolization (TACE) was planned.
resultsCTA demonstrated a markedly elongated celiac trunk measuring 5.0 cm in length (assessed by centerline curved planar reconstruction from the aortic origin to the continuation as the splenic artery). The trunk gave origin sequentially to the left gastric artery (LGA) and common hepatic artery (CHA) before continuing directly as the splenic artery (SA). The right hepatic artery was replaced, originating from the superior mesenteric artery (SMA; Michels type III). The left hepatic artery (LHA) and gastroduodenal artery (GDA) arose normally from the CHA. No other visceral arterial anomalies were identified. Vessel diameters were: celiac trunk 6 mm, SMA 7 mm, CHA 2.5 mm, LHA 2 mm, replaced right hepatic artery (RRHA) 2.5 mm. The patient successfully underwent selective TACE via the replaced right hepatic artery.
conclusionRecognition of such combined vascular variants through high-quality pre-procedural CTA with multiplanar imaging is essential to prevent inadvertent injury and ensure safe interventional procedures.
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