Three extremely rare anatomic variants of the hepatic artery

Abstract

Numerous, but not all, anatomical variants of the hepatic artery are known presently. New or extremely rare anatomical variations of the hepatic arteries can however be encountered in the current practice. The first case report was documented using computed tomography and refers to a rare variation: retroportal proper hepatic artery anastomosed with the superior mesenteric artery by an arc of Bühler. The second case report presents the results of a dissection study, where a middle hepatic artery (MHA) was found arising in a common gastrohepatic trunk with the right gastric artery, from the stem of the proper hepatic artery; that MHA coursed over the left hepatic artery, hiding it. Moreover, in case report 2, an accessory right hepatic artery was found arising from the superior mesenteric artery. In the third case reported in this article, an arterial loop was found joining the common hepatic artery and gastroduodenal artery and further sending an ascending branch, diagnosed as MHA, and a descending one, considered as a duplicate gastroduodenal artery. We could not find in any previous reports variants such as those found in case reports 2 and 3, thus we consider these to be extremely rare. However, surgeons and radiologists must be aware of such rare morphological possibilities of the hepatic artery.