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Novel anatomic variation: heptafurcation of the celiac trunk

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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.

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References

  1. Adachi B (1928) Das arteriensystem der Japaner, vol 2. Kenkyusha Press, Kyoto, pp 18–71

    Google Scholar 

  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

    Article  PubMed  Google Scholar 

  3. Augustyniak E (1965) Rare case of the absence of the celiac trunk. Folia Morphol (Warsz) 24:447–448

    CAS  Google Scholar 

  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 14:81–83

    Article  CAS  PubMed  Google Scholar 

  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

    Article  CAS  PubMed  Google Scholar 

  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

    Article  PubMed  Google Scholar 

  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

    Article  PubMed  Google Scholar 

  8. Chitra R (2010) Clinically relevant variations of the coeliac trunk. Singap Med J 51:216–219

    CAS  Google Scholar 

  9. Dilli Babu E, Khrab P (2013) Coeliac trunk variations: review with proposed new classification. Int J Anat Res 1:165–170

    Google Scholar 

  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

    Article  PubMed  Google Scholar 

  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 62:332–333

    CAS  PubMed  Google Scholar 

  12. Haller VA (1756) Icones anatomicae in quibus aliquae partes corporis humani delineatae proponuntur et arteriarum potissimum historia continetur. Vandenhoeck, Gottingen, pp 27–38

    Google Scholar 

  13. Hiatt JR, Gabbay J, Busuttil RW (1994) Surgical anatomy of the hepatic arteries in 1000 cases. Ann Surg 220:50–52

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  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

    Article  PubMed  Google Scholar 

  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

    Article  CAS  PubMed  Google Scholar 

  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

    Article  PubMed  Google Scholar 

  17. Lipshutz B (1917) A composite study of the coeliac axis artery. Ann Surg 65:159–169

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Macalister A (1883) Multiple renal arteries. J Anat Physiol 17:250–252

    CAS  PubMed  PubMed Central  Google Scholar 

  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

    Article  CAS  PubMed  Google Scholar 

  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

    Article  PubMed  Google Scholar 

  21. Miclaus GD, Matusz P (2012) Bilateral quadruple renal arteries. Clin Anat 25:973–976. https://doi.org/10.1002/ca.22083

    Article  PubMed  Google Scholar 

  22. Miclaus GD, Matusz P (2015) Bilateral triple renal arteries. Rom J Morphol Embryol 56:1507–1511

    PubMed  Google Scholar 

  23. Morettin LB, Baldwin-Price HK, Schreiber MH (1965) Congenital absence of the celiac axis trunk. Am J Roentgenol Radium Ther Nucl Med 95:727–730

    Article  CAS  PubMed  Google Scholar 

  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 1:75–91

    Article  Google Scholar 

  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 60:65–71

    Article  CAS  PubMed  Google Scholar 

  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

    PubMed  Google Scholar 

  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 12:183–186

    PubMed  Google Scholar 

  28. Paraskevas GK, Raikos A (2011) Multiple aberrant coeliac trunk ramifications. Singap Med J 52:e147-149

    Google Scholar 

  29. Pestemalci T, Mavi A, Yildiz YZ, Yildirim M, Gumusburun E (2009) Bilateral triple renal arteries. Saudi J Kidney Dis Transpl 20:468–470

    PubMed  Google Scholar 

  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 47:197–200

    CAS  PubMed  Google Scholar 

  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

    Article  Google Scholar 

  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

    Article  CAS  PubMed  Google Scholar 

  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 1016–1106

    Google Scholar 

  34. Sampaio FJ, Passos MA (1992) Renal arteries: anatomic study for surgical and radiological practice. Surg Radiol Anat 14:113–117

    Article  CAS  PubMed  Google Scholar 

  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 66:452–461

    CAS  PubMed  Google Scholar 

  36. Simmons RL, Tallent MB, Kjellstrand CM, Najarian JS (1971) Kidney transplantation from living donors with bilateral double renal arteries. Surgery 69:201–207

    CAS  PubMed  Google Scholar 

  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

    Article  PubMed  Google Scholar 

  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

    Article  PubMed  PubMed Central  Google Scholar 

  39. Vandamme JP, Bonte J (1985) The branches of the celiac trunk. Acta Anat (Basel) 122:110–114

    Article  CAS  Google Scholar 

  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 177:97–100

    Article  CAS  PubMed  Google Scholar 

  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

    Article  PubMed  Google Scholar 

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

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Correspondence to M. C. Rusu.

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Rusu, M.C., Manta, B.A. Novel anatomic variation: heptafurcation of the celiac trunk. Surg Radiol Anat 40, 457–463 (2018). https://doi.org/10.1007/s00276-018-1995-3

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