School of Medicine, The University of Queensland, Herston, Queensland, Australia.
Clin Anat. 2010 Nov;23(8):904-6. doi: 10.1002/ca.21024.
The presence of more than three coeliac trunk branches is a commonly encountered variant. Literature occasionally describes cases of middle or left colic arteries originating from the celiac trunks or its branches; however, the presence of an anomalous arterial connection between the celiac trunk and both the superior and inferior mesenteric arteries (SMA and IMA, respectively) has yet to be reported. Routine abdominal dissection of a male Caucasian cadaver, revealed the presence of an anomalous fourth arterial branch on the 4-cm long coeliac trunk. The course of this artery was traced, and it terminated by anastomosing with the marginal artery of the mesenteric circulation. The distal termination point of this anomalous fourth coeliac branch was the marginal artery, 5 cm medial of the splenic flexure, anastomosing almost perpendicularly. The diameter of this anomalous artery was comparable with the left gastric artery at their origins. The artery coursed inferiorlaterally toward the splenic flexure, passing immediately posterior to both the pancreas and the splenic vein. The anastomosis point of this artery, near Griffith's Point, is normally considered a watershed region with dual arterial supply from both the SMA and IMA, allowing collateral circulation. This region has a relatively higher susceptibility to irreversible damage in ischemic diseases because of lower perfusion, thus, the anastomosis of atypical coeliac branches represents a rare case for consideration. Awareness of the possibility of embryological variants will minimize the risk of complications in surgical or clinical procedures, and exploration of rare variants will benefit the understanding of vascular embryology.
腹腔干存在三条以上分支是一种常见的变异。文献偶尔会描述中结肠动脉或左结肠动脉起源于腹腔干或其分支的情况；然而，腹腔干与肠系膜上动脉（SMA）和肠系膜下动脉（IMA）之间存在异常动脉连接尚未见报道。对一名男性白种尸体进行常规腹部解剖时，发现腹腔干长 4 厘米处存在一条异常的第四动脉分支。追踪这条动脉的行程，它终末与肠系膜循环的边缘动脉吻合。这条异常第四腹腔干分支的远端终止点是边缘动脉，位于脾曲内侧 5 厘米处，几乎垂直吻合。这条异常动脉的直径与其起源处的胃左动脉相当。这条动脉向脾曲的下外侧走行，位于胰腺和脾静脉的后面。这条动脉的吻合点位于格里菲斯点附近，通常被认为是一个分水岭区域，有来自 SMA 和 IMA 的双重动脉供应，允许侧支循环。由于灌注较低，这个区域在缺血性疾病中更容易受到不可逆转的损害，因此，异常腹腔干分支的吻合是一个罕见的需要考虑的病例。对胚胎变异可能性的认识将最大限度地降低手术或临床操作中并发症的风险，对罕见变异的探索将有助于理解血管胚胎学。
