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肝动脉的三种极其罕见的解剖变异。

Three extremely rare anatomic variants of the hepatic artery.

作者信息

Rusu Mugurel Constantin, Jianu Adelina Maria, Sztika Dorina, Cuzino Dragos, Loreto Carla

机构信息

Discipline of Anatomy, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

出版信息

Ann Vasc Surg. 2011 Nov;25(8):1138.e1-7. doi: 10.1016/j.avsg.2011.03.011. Epub 2011 Jun 15.

Abstract

Numerous, but not all, anatomical variants of the hepatic artery are known presently. New or extremely rare anatomical variations of the hepatic arteries can however be encountered in the current practice. The first case report was documented using computed tomography and refers to a rare variation: retroportal proper hepatic artery anastomosed with the superior mesenteric artery by an arc of Bühler. The second case report presents the results of a dissection study, where a middle hepatic artery (MHA) was found arising in a common gastrohepatic trunk with the right gastric artery, from the stem of the proper hepatic artery; that MHA coursed over the left hepatic artery, hiding it. Moreover, in case report 2, an accessory right hepatic artery was found arising from the superior mesenteric artery. In the third case reported in this article, an arterial loop was found joining the common hepatic artery and gastroduodenal artery and further sending an ascending branch, diagnosed as MHA, and a descending one, considered as a duplicate gastroduodenal artery. We could not find in any previous reports variants such as those found in case reports 2 and 3, thus we consider these to be extremely rare. However, surgeons and radiologists must be aware of such rare morphological possibilities of the hepatic artery.

摘要

目前已知肝动脉存在多种解剖变异,但并非全部。然而,在当前的临床实践中,仍可能遇到新的或极为罕见的肝动脉解剖变异情况。首例病例报告通过计算机断层扫描记录,涉及一种罕见变异:门静脉后肝固有动脉通过布勒尔弓与肠系膜上动脉吻合。第二例病例报告展示了一项解剖学研究结果,发现一条肝中动脉(MHA)发自肝固有动脉干,与胃右动脉共干于一个共同的胃肝干;该肝中动脉走行于肝左动脉上方,将其掩盖。此外,在第二例病例中,发现一条副右肝动脉发自肠系膜上动脉。在本文报告的第三例病例中,发现一个动脉环连接肝总动脉和胃十二指肠动脉,进而发出一个上升支,诊断为肝中动脉,以及一个下降支,被认为是重复的胃十二指肠动脉。我们在以往任何报告中均未发现如第二例和第三例病例中所出现的变异情况,因此我们认为这些变异极为罕见。然而,外科医生和放射科医生必须了解肝动脉这种罕见的形态学变异可能性。

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