Unusual branching pattern of coeliac trunk – a case report

Introduction Coeliac trunk is one of the ventral splanchnic branches of abdominal aorta. It arises from the abdominal aorta opposite the intervertebral disc between T12 and L1 vertebrae. It has a short course of about 1,5 cm, after which it terminates by dividing into three branches; splenic artery, left gastric artery and the common hepatic artery. The common hepatic artery divides into gastroduodenal artery and hepatic artery proper. The gastroduodenal artery terminates by dividing into superior pancreaticoduodenal and right gastroepiploic arteries. The hepatic artery proper terminates by dividing into a right and a left hepatic artery, which supply the right and left lobes of the liver, respectively. The right hepatic artery gives a cystic branch which supplies the gallbladder. The right gastric artery may arise from the common hepatic or proper hepatic arteries. The left gastric artery, apart from supplying the stomach, gives one or two esophageal branches, which supply the terminal part of esophagus. The splenic artery gives pancreatic, left gastroepiploic and short gastric arteries in addition to the branches that supply the spleen. Here, we report the unusual branches of the coeliac trunk and its branches. Case Report During the dissection classes for medical undergraduate students, we found these variations in a male cadaver aged approximately 65 years. The coeliac trunk was about 5 cm long and terminated by dividing into common hepatic, splenic, left gastric and left hepatic arteries (Figure 1). The common hepatic artery divided into right hepatic and gastroduodenal arteries. The right hepatic artery supplied the gallbladder through a cystic branch. The course and branches of the gastroduodenal artery were normal. The splenic artery also had the usual course and branching pattern. The left gastric artery arose from the coeliac trunk and coursed along the lesser curvature. But it did not give any esophageal branches. The left hepatic artery was larger in size than the right hepatic artery and it originated directly from the coeliac trunk (Figures 1, 2). It coursed upward and to the left and entered the liver through the left end of the porta hepatis. It gave two branches before entering the liver. The upper among the two branches, supplied the terminal part of the esophagus and the lower branch supplied the part of the stomach adjoining esophagus. There were no other significant variations in the abdomen. Satheesha NAYAK B Naveen KUMAR Anitha GURU Surekha D SHETTY