Clinically relevant variations of the coeliac trunk.

INTRODUCTION Vascular patterns are important in the planning and performance of all upper abdominal surgical procedures. The coeliac trunk arises from the abdominal aorta and supplies the supracolic organs. Knowledge of variations of the coeliac trunk is important in procedures such as liver transplants for appropriate vascular ligation and anastomosis. METHODS The branching patterns of the coeliac trunk of 50 cadavers (40 male, 10 female) were recorded and analysed during routine dissection by undergraduate students from the Department of Anatomy, NRI Medical College and Siddhartha Medical College, India, from 2003 to 2008. Observations on clinically important variations of the coeliac trunk were noted. RESULTS The patterns of branching of the coeliac trunk were observed to vary from classical trifurcation to abnormal trifurcation, bifurcation, quadrifurcation, pentafurcation and even hexafurcation of the trunk. The additional branches of the trunk included the inferior phrenic artery, gastroduodenal artery, middle colic artery, dorsal pancreatic artery, jejunal or duodenal branch. Clinically relevant variations of the coeliac trunk were noted in many cases. CONCLUSION Variations of the coeliac trunk must be carefully understood in anastomosing the proper arteries in liver transplant surgeries. Knowledge of the variations of the branches of the coeliac trunk, such as the left gastric artery, gastroduodenal artery and middle colic artery, is important when performing surgery of the stomach, duodenum and pancreas.