Division of Anatomy, Department 1, Faculty of Dental Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Department of Anatomy and Embryology, Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania, Timişoara, Romania.
Folia Morphol (Warsz). 2022;81(2):365-371. doi: 10.5603/FM.a2021.0025. Epub 2021 Mar 22.
The coeliac trunk (CT) is well-known as trifurcated into the left gastric (LGA), common hepatic (CHA) and splenic (SA) arteries.
Scarce reports indicate that the CT could appear quadri-, penta-, hexa-, or even heptafurcated. Reports of CTs with six branches (hexafurcated CT) are few, less than ten. The hexafurcated CT variant was documented by a retrospective study of 93 computed tomography angiograms.
Two hexafurcated CTs were found. In one case an arc of Bühler was added to the inferior phrenic arteries, LGA, CHA and SA. In the second case the dorsal pancreatic artery was added to the other five branches. That arc of Bühler descended in front of the aorta to connect with the origin of the third jejunal artery. The CHA in that second case was trifurcated into the left and right hepatic arteries, and the gastroduodenal artery; the proper hepatic artery was absent.
Although the hexafurcated CT, as well as the trifurcated CHA, are rarely occurring and reported anatomic variants, this doesn't mean they could not be encountered during surgical or interventional procedures, which they would complicate if not recognised. Moreover, the arc of Bühler, the embryonic remnant, was not reported previously to insert into the CT as an additional branch of it.
腹腔干（CT）通常分为三支，分别为胃左动脉（LGA）、肝总动脉（CHA）和脾动脉（SA）。
罕见的报道表明，CT 可能出现四叉、五叉、六叉甚至七叉。关于具有六支（六叉 CT）的 CT 的报道很少，不到十例。通过对 93 例 CT 血管造影的回顾性研究，记录了六叉 CT 变异。
发现了两个六叉 CT。在一个病例中，膈下动脉、LGA、CHA 和 SA 增加了一个 Bühler 弓。在第二个病例中，背侧胰腺动脉增加到其他五个分支。Bühler 弓降位于主动脉前方，与第三空肠动脉的起源相连。第二个病例的 CHA 分为左、右肝动脉和胃十二指肠动脉；肝固有动脉不存在。
尽管六叉 CT 以及三叉 CHA 是罕见的发生和报道的解剖变异，但这并不意味着在手术或介入过程中不会遇到，如果不识别，它们可能会使手术复杂化。此外，Bühler 弓，即胚胎残余物，以前没有报道过作为 CT 的附加分支插入其中。
