Surgical and Radiologic Anatomy

, Volume 40, Issue 4, pp 457–463 | Cite as

Novel anatomic variation: heptafurcation of the celiac trunk

Anatomic Variations
  • 93 Downloads

Abstract

We report here anatomic variants which were found during a retrospective study of a male patient, 54 years old, evaluated in computed tomography: heptafurcation of the celiac trunk (CT) and bilateral double renal arteries. The seven branches of the heptafurcated CT were the (1) left and (2) right inferior phrenic arteries, the (3) splenic and (4) left gastric artery, the (5) common hepatic artery, further sending off the (a) proper, continued as left, hepatic artery and (b) the gastroduodenal artery, (6) a replaced right hepatic artery and (7) the dorsal pancreatic artery. To our knowledge, heptafurcation of the CT was not reported previously. The arterial variants have great importance during various surgical and interventional procedures and should be documented prior to respective procedures.

Keywords

Abdominal aorta Hepatic artery Splenic artery Phrenic artery Renal artery Gastric artery, Pancreatic artery 

Notes

Author contributions

Data collection and management: MCR. Data analysis: MCR, BAM. Manuscript writing: BAM. Literature search: BAM.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Adachi B (1928) Das arteriensystem der Japaner, vol 2. Kenkyusha Press, Kyoto, pp 18–71Google Scholar
  2. 2.
    Armstrong PJ, Franklin DP (2006) Superior mesenteric artery branch aneurysm with absence of the celiac trunk. Vascular 14:109–112.  https://doi.org/10.2310/6670.2006.00015 CrossRefPubMedGoogle Scholar
  3. 3.
    Augustyniak E (1965) Rare case of the absence of the celiac trunk. Folia Morphol (Warsz) 24:447–448Google Scholar
  4. 4.
    Bayazit M, Gol MK, Zorlutuna Y, Tasdemir O, Bayazit K (1992) Bilateral triple renal arteries in a patient with iliac artery occlusion: a case report. Surg Radiol Anat 14:81–83CrossRefPubMedGoogle Scholar
  5. 5.
    Bordei P, Sapte E, Iliescu D (2004) Double renal arteries originating from the aorta. Surg Radiol Anat 26:474–479.  https://doi.org/10.1007/s00276-004-0272-9 CrossRefPubMedGoogle Scholar
  6. 6.
    Cases C, Garcia-Zoghby L, Manzorro P, Valderrama-Canales FJ, Munoz M, Vidal M, Simon C, Sanudo JR, McHanwell S, Arrazola J (2017) Anatomical variations of the renal arteries: cadaveric and radiologic study, review of the literature, and proposal of a new classification of clinical interest. Ann Anat 211:61–68.  https://doi.org/10.1016/j.aanat.2017.01.012 CrossRefPubMedGoogle Scholar
  7. 7.
    Chen H, Yano R, Emura S, Shoumura S (2009) Anatomic variation of the celiac trunk with special reference to hepatic artery patterns. Ann Anat 191:399–407.  https://doi.org/10.1016/j.aanat.2009.05.002 CrossRefPubMedGoogle Scholar
  8. 8.
    Chitra R (2010) Clinically relevant variations of the coeliac trunk. Singap Med J 51:216–219Google Scholar
  9. 9.
    Dilli Babu E, Khrab P (2013) Coeliac trunk variations: review with proposed new classification. Int J Anat Res 1:165–170Google Scholar
  10. 10.
    Douard R, Chevallier JM, Delmas V, Cugnenc PH (2006) Clinical interest of digestive arterial trunk anastomoses. Surg Radiol Anat 28:219–227.  https://doi.org/10.1007/s00276-006-0098-8 CrossRefPubMedGoogle Scholar
  11. 11.
    Geraci C, Mule G, Geraci G, Mogavero M, Cerasola G (2010) Bilateral double renal arteries and bilateral double renal veins. A color-Doppler sonographic finding in a patient with arterial hypertension. Minerva Urol Nefrol 62:332–333PubMedGoogle Scholar
  12. 12.
    Haller VA (1756) Icones anatomicae in quibus aliquae partes corporis humani delineatae proponuntur et arteriarum potissimum historia continetur. Vandenhoeck, Gottingen, pp 27–38Google Scholar
  13. 13.
    Hiatt JR, Gabbay J, Busuttil RW (1994) Surgical anatomy of the hepatic arteries in 1000 cases. Ann Surg 220:50–52CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Iezzi R, Cotroneo AR, Giancristofaro D, Santoro M, Storto ML (2008) Multidetector-row CT angiographic imaging of the celiac trunk: anatomy and normal variants. Surg Radiol Anat 30:303–310.  https://doi.org/10.1007/s00276-008-0324-7 CrossRefPubMedGoogle Scholar
  15. 15.
    Khamanarong K, Prachaney P, Utraravichien A, Tong-Un T, Sripaoraya K (2004) Anatomy of renal arterial supply. Clin Anat 17:334–336.  https://doi.org/10.1002/ca.10236 CrossRefPubMedGoogle Scholar
  16. 16.
    Kishi Y, Imamura H, Sugawara Y, Sano K, Kaneko J, Kokudo N, Makuuchi M (2010) Evaluation of donor vasculobiliary anatomic variations in liver graft procurements. Surgery 147:30–39.  https://doi.org/10.1016/j.surg.2009.06.017 CrossRefPubMedGoogle Scholar
  17. 17.
    Lipshutz B (1917) A composite study of the coeliac axis artery. Ann Surg 65:159–169CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Macalister A (1883) Multiple renal arteries. J Anat Physiol 17:250–252PubMedPubMedCentralGoogle Scholar
  19. 19.
    Marco-Clement I, Martinez-Barco A, Ahumada N, Simon C, Valderrama JM, Sanudo J, Arrazola J (2016) Anatomical variations of the celiac trunk: cadaveric and radiological study. Surg Radiol Anat 38:501–510.  https://doi.org/10.1007/s00276-015-1542-4 CrossRefPubMedGoogle Scholar
  20. 20.
    Matusz P, Miclaus GD, Ples H, Tubbs RS, Loukas M (2012) Absence of the celiac trunk: case report using MDCT angiography. Surg Radiol Anat 34:959–963.  https://doi.org/10.1007/s00276-012-0989-9 CrossRefPubMedGoogle Scholar
  21. 21.
    Miclaus GD, Matusz P (2012) Bilateral quadruple renal arteries. Clin Anat 25:973–976.  https://doi.org/10.1002/ca.22083 CrossRefPubMedGoogle Scholar
  22. 22.
    Miclaus GD, Matusz P (2015) Bilateral triple renal arteries. Rom J Morphol Embryol 56:1507–1511PubMedGoogle Scholar
  23. 23.
    Morettin LB, Baldwin-Price HK, Schreiber MH (1965) Congenital absence of the celiac axis trunk. Am J Roentgenol Radium Ther Nucl Med 95:727–730CrossRefPubMedGoogle Scholar
  24. 24.
    Nelson TM, Pollak R, Jonasson O, Abcarian H (1988) Anatomic variants of the celiac, superior mesenteric, and inferior mesenteric arteries and their clinical relevance. Clin Anat 1:75–91CrossRefGoogle Scholar
  25. 25.
    Okada S, Ohta Y, Shimizu T, Nakamura M, Yaso K (1983) A rare anomalous case of absence of the celiac trunk–the left gastric, the splenic and the common hepatic arteries arose from the abdominal aorta independently. Okajimas Folia Anat Jpn 60:65–71CrossRefPubMedGoogle Scholar
  26. 26.
    Ozbulbul NI (2011) CT angiography of the celiac trunk: anatomy, variants and pathologic findings. Diagn Interv Radiol 17:150–157.  https://doi.org/10.4261/1305-3825.DIR.3283-10.1 PubMedGoogle Scholar
  27. 27.
    Ozkan U, Oguzkurt L, Tercan F, Kizilkilic O, Koc Z, Koca N (2006) Renal artery origins and variations: angiographic evaluation of 855 consecutive patients. Diagn Interv Radiol 12:183–186PubMedGoogle Scholar
  28. 28.
    Paraskevas GK, Raikos A (2011) Multiple aberrant coeliac trunk ramifications. Singap Med J 52:e147-149Google Scholar
  29. 29.
    Pestemalci T, Mavi A, Yildiz YZ, Yildirim M, Gumusburun E (2009) Bilateral triple renal arteries. Saudi J Kidney Dis Transpl 20:468–470PubMedGoogle Scholar
  30. 30.
    Rusu MC (2006) Human bilateral doubled renal and testicular arteries with a left testicular arterial arch around the left renal vein. Rom J Morphol Embryol 47:197–200PubMedGoogle Scholar
  31. 31.
    Rusu MC, Jianu AM, Sztika D, Cuzino D, Loreto C (2011) Three extremely rare anatomic variants of the hepatic artery. Ann Vasc Surg 25:1138.e1–1138.e7.  https://doi.org/10.1016/j.avsg.2011.03.011 CrossRefGoogle Scholar
  32. 32.
    Rusu MC, Vlad M, Voinea LM, Curca GC, Sisu AM (2008) Detailed anatomy of a left accessory aberrant colic artery. Surg Radiol Anat 30:595–599.  https://doi.org/10.1007/s00276-008-0362-1 CrossRefPubMedGoogle Scholar
  33. 33.
    Sahni D, Aggarwal A, Gupta T, Kaur H, Gupta R, Chawla K, Saini N, Garg S, Singla A, Deep A, Singh HJ, Shekhawat D, Rapotra M (2016) Abdominal Aorta. In: Tubbs RS, Shoja MM, Loukas M (eds) Bergman’s comprehensive encyclopedia of human anatomic variation. John Wiley, Hoboken, pp 1016–1106Google Scholar
  34. 34.
    Sampaio FJ, Passos MA (1992) Renal arteries: anatomic study for surgical and radiological practice. Surg Radiol Anat 14:113–117CrossRefPubMedGoogle Scholar
  35. 35.
    Shoumura S, Emura S, Utsumi M, Chen H, Hayakawa D, Yamahira T, Isono H (1991) Anatomical study on the branches of the celiac trunk (IV). Comparison of the findings with Adachi’s classification. Kaibogaku Zasshi 66:452–461PubMedGoogle Scholar
  36. 36.
    Simmons RL, Tallent MB, Kjellstrand CM, Najarian JS (1971) Kidney transplantation from living donors with bilateral double renal arteries. Surgery 69:201–207PubMedGoogle Scholar
  37. 37.
    Song SY, Chung JW, Yin YH, Jae HJ, Kim HC, Jeon UB, Cho BH, So YH, Park JH (2010) Celiac axis and common hepatic artery variations in 5002 patients: systematic analysis with spiral CT and DSA. Radiology 255:278–288.  https://doi.org/10.1148/radiol.09090389 CrossRefPubMedGoogle Scholar
  38. 38.
    Sylvia S, Kakarlapudi SV, Vollala VR, Potu BK, Jetti R, Bolla SR, Rao M, Pamidi N (2009) Bilateral variant testicular arteries with double renal arteries. Cases J 2:114.  https://doi.org/10.1186/1757-1626-2-114 CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Vandamme JP, Bonte J (1985) The branches of the celiac trunk. Acta Anat (Basel) 122:110–114CrossRefGoogle Scholar
  40. 40.
    Yamaki K, Tanaka N, Matsushima T, Miyazaki K, Yoshizuka M (1995) A rare case of absence of the celiac trunk: the left gastric, the splenic, the common hepatic and the superior mesenteric arteries arising independently from the abdominal aorta. Ann Anat 177:97–100CrossRefPubMedGoogle Scholar
  41. 41.
    Yi SQ, Terayama H, Naito M, Hirai S, Alimujang S, Yi N, Tanaka S, Itoh M (2008) Absence of the celiac trunk: case report and review of the literature. Clin Anat 21:283–286.  https://doi.org/10.1002/ca.20627 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Anatomy, Department 1, Faculty of Dental Medicine“Carol Davila” University of Medicine and PharmacyBucharestRomania

Personalised recommendations