Bezabih Yoseph Solomon
Department of Surgery, School of Medicine, Debre Markos University, PO Box 26, Debre Markos, Ethiopia.
Addis Ababa University, College of Medicine and Health Sciences, Departmrnt of Surgery, Addis Ababa, Ethiopia.
Radiol Case Rep. 2023 Dec 20;19(3):949-952. doi: 10.1016/j.radcr.2023.09.098. eCollection 2024 Mar.
The celiac trunk is the first branch of the abdominal aorta which arises from the anterior surface of the abdominal aorta and usually extends 1-2 cm before it branches into 3 branch arteries: the left gastric artery, the common hepatic artery, and the splenic artery. It is essential to comprehend the intricate arterial branch anatomy of the abdominal aorta to carry out abdominal surgeries as well as interventional radiology procedures safely. A 63-year-old woman who had been experiencing right upper quadrant adnominal pain for 2 months along with weight loss and appetite presented to the surgical unit of Tikur Ambessa Hospital. On exams, her vital signs were stable. Her abdominal exams were unremarkable. She was evaluated with an abdominal ultrasound which detected a mass arising from the gallbladder. With the impression of gallbladder mass contrast-enhanced computed tomography was done and revealed a rare anatomic variant of the celiac artery where the celiac artery was absent and the left gastric, the common hepatic, and the splenic arteries arise independently from the abdominal aorta. Clinicians should be aware of the presence of rare arterial variations because these changes can have a variety of therapeutic implications when performing surgical procedures like liver transplant, celiac artery resection such as the Appleby procedure for pancreatic and stomach cancer, or during interventional radiology procedures like transarterial chemoembolization.
腹腔干是腹主动脉的第一分支，它从腹主动脉前表面发出，通常在分支为3条分支动脉（胃左动脉、肝总动脉和脾动脉）之前延伸1 - 2厘米。为了安全地进行腹部手术以及介入放射学操作，了解腹主动脉复杂的动脉分支解剖结构至关重要。一名63岁女性，右上腹腹痛2个月，伴有体重减轻和食欲减退，就诊于提库尔安贝萨医院外科。检查时，她的生命体征稳定。腹部检查无异常。她接受了腹部超声检查，发现胆囊有一个肿块。基于胆囊肿块的印象，进行了增强CT检查，结果显示腹腔动脉存在一种罕见的解剖变异，即腹腔动脉缺如，胃左动脉、肝总动脉和脾动脉分别独立地从腹主动脉发出。临床医生应意识到罕见动脉变异的存在，因为在进行诸如肝移植、腹腔动脉切除术（如用于胰腺癌和胃癌的阿普比手术）等外科手术，或在进行如经动脉化疗栓塞等介入放射学操作时，这些改变可能会产生多种治疗影响。
