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胃网膜左动脉的异常重复及胰腺内走行易损:一种罕见的解剖变异

Unusual duplication and vulnerable intrapancreatic course of the left gastroepiploic artery: a rare anatomical variation.

作者信息

Kumar Naveen, Aithal Ashwini P, Guru Anitha

机构信息

Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Manipal, India.

出版信息

Surg Radiol Anat. 2019 Mar;41(3):351-353. doi: 10.1007/s00276-019-02188-w. Epub 2019 Feb 5.

Abstract

The left gastroepiploic artery (LGEA) is the least described artery in the medical literature. Unusual variations of this artery might lead to vascular injuries, causing intraoperative bleeding after surgery. We observed rare vascular variations in an adult male cadaver. The left gastroepiploic artery after its origin from splenic artery pierced the pancreatic parenchyma at its posterior surface. After a short intrapancreatic course, the LGEA emerged out from the superior border of the body of the pancreas. LGEA then trifurcated into an omental branch, duplicated LGEA and another branch that continued as the main trunk of LGEA. Main LGEA and duplicated LGEA coursed towards the greater curvature of the stomach. The main LGEA ended by anastomosing with the right gastroepiploic artery, while the duplicated LGEA ended at the greater curvature of the stomach by ramifying into minute branches on the walls of the stomach and gave few gastric branches to supply the stomach and also supplied the greater omentum. This variation was associated with the presence of an accessory splenic artery. Anatomists, surgeons, and radiologists should be aware of such anomalous vascular variations as it could help to minimize complications related to pancreatectomy, omentoplasty, and resection of pancreatic tumors.

摘要

胃网膜左动脉(LGEA)是医学文献中描述最少的动脉。该动脉的异常变异可能导致血管损伤,引起术后术中出血。我们在一具成年男性尸体中观察到罕见的血管变异。胃网膜左动脉起源于脾动脉后,在胰腺后表面穿入胰腺实质。在胰腺内走行一段短距离后,胃网膜左动脉从胰体上缘穿出。然后胃网膜左动脉分为一支网膜支、重复的胃网膜左动脉和另一支作为胃网膜左动脉主干延续的分支。胃网膜左动脉主干和重复的胃网膜左动脉向胃大弯走行。胃网膜左动脉主干与胃网膜右动脉吻合而终,而重复的胃网膜左动脉在胃大弯处分支成胃壁上的微小分支而终,并发出少数胃支供应胃,还供应大网膜。这种变异与副脾动脉的存在有关。解剖学家、外科医生和放射科医生应了解这种异常的血管变异,因为这有助于将与胰腺切除术、网膜成形术和胰腺肿瘤切除术相关的并发症降至最低。

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