Duddu Yashwanth, Bhingardeo Alka V, Darna Srija, Ganti Savithru, Chandrupatla Mrudula
Anatomy, All India Institute of Medical Sciences, Bibinagar, Hyderabad, IND.
Cureus. 2024 Aug 1;16(8):e65932. doi: 10.7759/cureus.65932. eCollection 2024 Aug.
Vascular variations of the coeliac trunk are relatively common, with documented occurrences including trifurcation of the common hepatic artery (CHA) and the presence of accessory and replaced hepatic arteries. This case report describes a novel variation wherein the CHA trifurcates into the proper hepatic artery (PHA), gastroduodenal artery, and accessory PHA (APHA). This particular trifurcation pattern has not been previously recorded. The APHA further branches into two arteries that supply the right lobe of the liver. Additionally, a middle hepatic artery (MHA), originating from the PHA, was identified alongside the right and left hepatic arteries. The MHA serves as a hilar artery that drains segment IV of the liver. This anatomical variant does not conform to any existing coeliac trunk classifications. Understanding this unique arterial pattern is crucial for liver transplantation, as well as procedures involving the pancreas, duodenum, and gallbladder, and for interventional techniques such as transcatheter arterial chemoembolization and transarterial radionuclide therapy.
腹腔干的血管变异相对常见，已记录的情况包括肝总动脉（CHA）的三叉分支以及副肝动脉和替代肝动脉的存在。本病例报告描述了一种新的变异，其中CHA三叉分为肝固有动脉（PHA）、胃十二指肠动脉和副肝固有动脉（APHA）。这种特殊的三叉分支模式以前尚未有记录。APHA进一步分支为两条供应肝右叶的动脉。此外，在右肝动脉和左肝动脉旁发现了一条起源于PHA的肝中动脉（MHA）。MHA作为一条肝门动脉引流肝IV段。这种解剖变异不符合任何现有的腹腔干分类。了解这种独特的动脉模式对于肝移植以及涉及胰腺、十二指肠和胆囊的手术以及诸如经导管动脉化疗栓塞和经动脉放射性核素治疗等介入技术至关重要。
