Michalinos Adamantios, Schizas Dimitrios, Ntourakis Dimitrios, Filippou Dimitrios, Troupis Theodore
Department of Anatomy and Surgical Anatomy, School of Medicine, National and Kapodistrian University of Athens, Tetrapoleos 18, 75 Mikras Asias Str, 11527, Athens, Greece.
1st Department of Surgery, Faculty of Medicine, National and Kapodistrian University of Athens, Tetrapoleos 18, 11527, Athens, Greece.
Surg Radiol Anat. 2019 May;41(5):575-581. doi: 10.1007/s00276-018-2168-0. Epub 2018 Dec 14.
The arc of Bühler, an anastomotic vessel between celiac artery and superior mesenteric artery, is a rare anatomic variation. Various radiologic and surgical procedures can be affected by its existence. We aim to review all available information and identify possible clinical implications.
A systematic review was conducted in accordance to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. The following terms were utilized in various combinations: "Bühler", "arc of Bühler", "visceral aneurysm", "pancreaticoduodenal arcades".
Only 53 cases have been described until today in the literature. The arc of Bühler enhances collateral circulation between celiac artery and superior mesenteric artery alongside with pancreaticoduodenal arcades and dorsal pancreatic artery. Computerized tomography and angiography are the main studies used for its detection and evaluation. Aneurysms of Bühler's arc have been rarely described and seem to share common pathophysiological mechanisms with aneurysms of the pancreaticoduodenal arcades.
Various radiologic and surgical procedures such as embolization or pancreaticoduodenectomy are potentially affected by its existence.
布勒动脉弓是腹腔干动脉与肠系膜上动脉之间的吻合血管，是一种罕见的解剖变异。其存在会影响各种放射学和外科手术操作。我们旨在回顾所有可用信息并确定可能的临床意义。
根据系统评价和Meta分析的首选报告项目（PRISMA）指南进行系统评价。以下术语以各种组合形式使用：“布勒”、“布勒动脉弓”、“内脏动脉瘤”、“胰十二指肠动脉弓”。
迄今为止，文献中仅描述了53例病例。布勒动脉弓与胰十二指肠动脉弓及胰背动脉一起增强了腹腔干动脉与肠系膜上动脉之间的侧支循环。计算机断层扫描和血管造影是用于其检测和评估的主要检查方法。布勒动脉弓的动脉瘤很少被描述，似乎与胰十二指肠动脉弓的动脉瘤具有共同的病理生理机制。
各种放射学和外科手术操作，如栓塞或胰十二指肠切除术，可能会受到其存在的影响。
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