The coexistence of both replaced proper hepatic and gastroduodenal arteries due to the common hepatic artery absence

Surg Radiol Anat. 2017 Nov;39(11):1293-1296. doi: 10.1007/s00276-017-1866-3. Epub 2017 May 15.

Abstract

Anatomical variants of the celiac trunk (CT) branches and especially these of hepatic arteries (HAs) are among the most common variants of the arterial tree. The knowledge of the wide variability in hepatic arterial supply is of paramount importance in hepatobiliary, pancreatic, gastric, and esophageal surgery, as well as in liver transplantations. The purpose of this case report is to describe a rare variant discovered during abdominal dissection of a 74-year-old male cadaver of Greek origin, in which the common hepatic artery was absent and its branches, the proper hepatic artery (PHA) and the gastroduodenal artery (GDA) had an aberrant and separate origin. The entire arterial supply to the liver derived from the aberrant PHA, that originating from the superior mesenteric artery and was named as PHA (RPHA). The RPHA, after a course posterior to the portal vein, terminated into the right and left HAs, at the hilum. The GDA originated from the CT, as well as the left gastric and splenic artery. The right gastric artery originated from the PHA, as usual. The current case emphasizes the necessity of preoperative imaging when evaluating the resectability of a tumor in hepatobiliary and pancreatic area taking into account the possible vascular variations. Abdominal surgeon should be aware of any aberrancy to avoid potential iatrogenic injury and lethal complications.

Keywords: Aberrant gastroduodenal artery; Aberrant proper hepatic artery; Celiac trunk; Common hepatic artery absence; Variation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anatomic Variation
  • Cadaver
  • Duodenum / blood supply*
  • Hepatic Artery / abnormalities*
  • Humans
  • Male
  • Mesenteric Artery, Superior / abnormalities*
  • Stomach / blood supply*