Raikos A, Paraskevas G K, Natsis K, Tzikas A, Njau S N
Department of Anatomy, Medical School, Aristotle University of Thessaloniki, Greece.
Rom J Morphol Embryol. 2010;51(3):585-7.
We report on a unique clinically and surgically significant case of multiple abdominal aorta variations. Specifically, the left inferior phrenic, left gastric and splenic artery arose in common from the left aspect of the aorta constituting a common phrenogastrosplenic trunk, while the common hepatic artery originated separately from the midline of the anterior aspect of the aorta just inferiorly to the trunk. An accessory right hepatic artery arises from the right-anterior aspect of the abdominal aorta adjacent to superior mesenteric artery origin. On the left side, two renal arteries were observed. Moreover, the left gonadal artery exhibited a high origin, arising inferiorly to the upper left renal artery. We discuss about the embryological development of abdominal aorta arterial abnormalities and we attempt to sort the noticed variations according to existing classification in the literature. It is highlighted that the thorough knowledge of these arterial variations is important for the success of upper abdomen surgical operations such as liver and kidney transplantation, kidney preservation, abdominal aorta related vascular surgery, treatment of hepatocellular carcinoma by transcatheter arterial chemoembolizations as well as imaging interpretation of the region. Preoperative selective angiography or other abdominal aorta imaging studies are helpful for arterial variation demonstration and a precious tool for appropriate surgery planning.
我们报告了一例独特的、具有临床和手术重要意义的腹主动脉多处变异病例。具体而言，左膈下动脉、左胃动脉和脾动脉共同起自主动脉左侧，构成膈胃脾共同干，而肝总动脉则单独起自主动脉前侧中线，恰好在该干下方。一条副右肝动脉起自腹主动脉右前侧，紧邻肠系膜上动脉起始处。在左侧，观察到两条肾动脉。此外，左性腺动脉起源较高，起自左肾动脉上方的下方。我们讨论了腹主动脉动脉异常的胚胎发育，并尝试根据文献中现有的分类对所观察到的变异进行分类。强调了对这些动脉变异的深入了解对于上腹部手术的成功至关重要，如肝和肾移植、肾脏保存、腹主动脉相关血管手术、经导管动脉化疗栓塞治疗肝细胞癌以及该区域的影像学解读。术前选择性血管造影或其他腹主动脉影像学检查有助于显示动脉变异，是进行适当手术规划的宝贵工具。
