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| celiac trunk | |
|---|---|
| Name | Celiac trunk |
| Latin | truncus coeliacus |
| Origin | abdominal aorta |
| Branches | left gastric artery; splenic artery; common hepatic artery |
| Precursor | vitelline arteries |
celiac trunk The celiac trunk is a major visceral artery arising from the abdominal aorta that supplies several abdominal organs. It is located just below the diaphragm near the level of the T12 vertebra and gives rise to three primary branches supplying the stomach, spleen, liver, pancreas and proximal duodenum. Surgeons, radiologists, and anatomists often encounter the celiac trunk in procedures and imaging related to the Diaphragm, Abdomen, Aorta, Esophagus, and Pancreas.
The trunk originates from the anterior aspect of the abdominal aorta inferior to the Aortic hiatus of the Diaphragm and superior to the origin of the Superior mesenteric artery. It courses a short distance before dividing, typically within the bounds of the Arterial circle supplying foregut derivatives such as the Stomach, Spleen, Liver, and proximal Duodenum. Nearby anatomical landmarks include the Crura of diaphragm, Left renal vein, and the anterior surface of the Vertebral column at T12. Its relations are important in operative approaches to the Pancreaticoduodenectomy and in retroperitoneal dissections familiar to surgeons from institutions like Mayo Clinic and Johns Hopkins Hospital.
Classically the celiac trunk bifurcates into three named branches: the left gastric artery, the splenic artery, and the common hepatic artery. The left gastric artery ascends toward the lesser curvature of the Stomach and anastomoses with branches from the Esophageal arteries and nodes encountered during operations at Mount Sinai Hospital. The splenic artery runs along the superior border of the Pancreas to the Spleen and gives pancreatic and short gastric branches relevant to procedures performed at Cleveland Clinic. The common hepatic artery proceeds toward the liver, giving the gastroduodenal artery and proper hepatic artery that supply the Liver and gallbladder; these patterns are central to transplants at University of Pittsburgh Medical Center and resections at Memorial Sloan Kettering Cancer Center.
Anatomic variants of the trunk are common and clinically significant. A classic variant is the hepatosplenic trunk or gastrosplenic trunk, and rarer configurations include a celiacomesenteric trunk where the trunk shares a common origin with the Superior mesenteric artery, a pattern discussed in case series from Radiological Society of North America meetings. Accessory hepatic arteries, replaced right hepatic artery arising from the Superior mesenteric artery, or a replaced left hepatic artery from the left gastric artery are important in transplant and oncologic surgery performed at centers like Stanford Health Care and Charité – Universitätsmedizin Berlin. Aneurysms and compression syndromes such as those described by clinicians at Cleveland Clinic and researchers at Mayo Clinic further illustrate variant-related pathology.
Embryologically the trunk develops from the ventral segmental vitelline arteries that supply the yolk sac, with fusion and remodeling giving rise to the major foregut vessels. Genes and signaling pathways characterized in research at institutions such as Harvard Medical School, Max Planck Institute for Molecular Genetics, and Broad Institute regulate vascular patterning during formation of the Foregut and adjacent structures. Abnormal persistence or regression of vitelline channels can produce the celiac variants reported in embryology texts used at Oxford University Press and Cambridge University Press.
The celiac trunk provides arterial inflow to foregut-derived organs: the stomach via the left gastric artery, the spleen via the splenic artery, and the liver and biliary tree via the common hepatic artery. Collateral networks link celiac branches with the Superior mesenteric artery and Inferior mesenteric artery territories, which is clinically relevant in chronic occlusive disease managed at centers including Vascular Society conferences and vascular surgery units at Johns Hopkins Hospital.
Pathologies include occlusion, atherosclerotic stenosis, aneurysm formation, and external compression such as median arcuate ligament syndrome (MALS). MALS may present with postprandial pain and weight loss and has been the subject of studies by teams at Mayo Clinic and Cleveland Clinic; endovascular and surgical options involve interventionalists from Society of Interventional Radiology. Knowledge of variant anatomy is critical to avoid ischemia during pancreatoduodenectomy, hepatic resection, and splenectomy at tertiary centers such as Memorial Sloan Kettering Cancer Center and UCSF Medical Center.
Imaging modalities include computed tomography angiography (CTA), magnetic resonance angiography (MRA), and digital subtraction angiography (DSA) often performed by radiology departments at Radiological Society of North America meetings and hospitals like Massachusetts General Hospital. Preoperative mapping identifies replaced or accessory hepatic arteries before procedures at transplant centers such as UCLA Health and Baylor College of Medicine. Endovascular interventions—stenting, coil embolization—and surgical decompression by release of the median arcuate ligament or arterial reconstruction are carried out by vascular and hepatopancreatobiliary surgeons trained at institutions including Royal College of Surgeons programs and professional societies like American College of Surgeons.
Category:Arteries of the abdomen