Chen Jesse, Ramjit Amit, Ahmad Noor
Department of Interventional Radiology, Staten Island University Hospital, 475 Seaview Ave, Staten Island, NY 10305 USA.
CVIR Endovasc. 2018;1(1):23. doi: 10.1186/s42155-018-0032-2. Epub 2018 Nov 30.
Presented here is a rare case of a gastroduodenal artery (GDA) replaced to the superior mesenteric artery with continuation into an accessory left hepatic artery. To the authors' knowledge, this rare anomaly is not described previously. Replaced GDA is reported, however without continuation into an accessory LHA.
A 74-year-old male with recurrent peptic ulcer disease presented with acute onset melena. This anomaly was discovered during abdominal angiography performed for treatment of a hemorrhagic duodenal ulcer. Initial celiac and common hepatic artery (CHA) subselection and angiography demonstrated no branch vessels. Angiography via the superior mesenteric artery demonstrated free extravasation into the duodenum and distal perfusion of the left hepatic lobe.
This is a rare variant of hepatic arterial anatomy. Importantly, this variant challenges a previously described anatomical model that attempts to explain observed CHA variation.
本文介绍了一例罕见病例，即胃十二指肠动脉（GDA）替代至肠系膜上动脉并延续为副左肝动脉。据作者所知，此前未描述过这种罕见的异常情况。不过有报道称存在替代的GDA，但未延续为副左肝动脉。
一名74岁患有复发性消化性溃疡疾病的男性出现急性黑便。这种异常情况是在为治疗出血性十二指肠溃疡而进行的腹部血管造影检查中发现的。最初对腹腔干和肝总动脉（CHA）进行超选择性造影未显示分支血管。通过肠系膜上动脉进行的血管造影显示造影剂自由外渗至十二指肠以及左肝叶的远端灌注。
这是一种罕见的肝动脉解剖变异。重要的是，这种变异对之前描述的试图解释观察到的CHA变异的解剖模型提出了挑战。
