Anatomical Variations of Celiac Trunk: An Angiographic Study

Background : Anatomical variations of the hepatic arteries and celiac trunk are of considerable importance in liver transplants, laparoscopic surgery, radiological abdominal interventions and penetrating injuries to the abdomen. Understanding and classifying the variations in CTA is imperative in view of its relevance in various clinical and surgical cases. Knowledge of the existence of variations in the hepatic arteries is useful for planning and conducting surgical or radiological procedures of the upper abdomen. It is important during biliary tract operations, liver transplants, chemo-embolization of a liver neoplasm. Objective: The purpose of this study is to examine the anatomical variations that occur in the celiac trunk and its branches using multidetector CT (MDCT) and dissecting cadavers as well as assess prevalence of the different variations in the Egyptian population. Patient and Methods: This is a retrospective study carried out in Cairo university hospital and private radiology center from August 2013 to May 2015. It included 12 adult cadavers done at the Department of Anatomy of Cairo university hospital and 131 adult patients underwent abdominal dynamic enhanced MDCT and angiography at Radiology Department of Cairo University hospital. Results: Out of 143 cases, 97 cases (67.8%) showed the classic trifurcation of the celiac trunk without any anatomical variations; sixty males and thirty seven females. Statistical analysis showed insignificant difference between both sexes. The most frequent variations of the branches of the celiac trunk observed in this study was right hepatic artery from superior mesenteric artery (12.6%), while the least common variations observed were the common hepatic artery from superior mesenteric artery and left hepatic artery from celiac trunk (1.4%). Conclusion: Anatomical variations of the celiac trunk are not infrequent and are of considerable importance in liver transplants, laparoscopic surgery, radiological abdominal interventions and penetrating injuries to the abdomen. Reformatted three-dimensional MDCT images allow detailed visualization of the complex vascular anatomy. Therefore, small Correspondence to: Dr. Ahmad S. Aw ad, The Department of Diagnostic & Interventional Radiology, Faculty of Medicine, Cairo University, Egypt vessel abnormalities may be detected with greater frequency in symptomatic and asymptomatic patients using these techniques.