An unusual case of a tortuous abdominal aorta with a common celiacomesenteric trunk: demonstrated by angiography

The abdominal aorta (AA) begins at the aortic hiatus of the diaphragm, in front of the lower border of the body of the last thoracic vertebra and descending in front of the vertebral column and ends on the body of the fourth lumbar vertebra, commonly a little to the left of the middle line by dividing into the two common iliac arteries. The celiac trunk (CeT) and superior mesenteric artery (SMA) are the two widest vessels arising from the ventral aorta. The celiac trunk divides into the left gastric, common hepatic and splenic arteries. SMA and the coeliac trunk can arise from the ventral aorta as a common origin. The unusual embryologic development of the ventral splanchnic arteries can lead to considerable variations. Many variational patterns of the CeT have been described. A review by Yi et al. summarized that only 87.7% of CeTs exhibited classic trifurcation. An incomplete CeT, namely bifurcation, accounted for 5.8–24.1%. Aside from these variations, the CeT itself may be absent and its branches can arise directly from the aorta. Moreover, in rare cases, the CeT and SMA may be fused into a common celiacomesenteric trunk (CMT), of which the incidence was mentioned as 0–11% (average, 1.5%). Many different types of catheter or intra-aortic balloon pumping are commonly used either to diagnose vascular diseases or treat them via the AA. In abnormalities like a tortuous AA, use of catheters is advised with great caution; straight-tipped catheters are discouraged.