Coeliac trunk and left gastric artery variation: a clinical interpretation

Background: The coeliac trunk (hepatolienogastric trunk or “Tripus Hallery”) is the most important artery of the foregut. It arises at the level of T12 vertebra from the abdominal aorta. The branches of coeliac trunk (left gastric, common hepatic and splenic) considered as the normal appearance. The coeliac trunk variations have been reported which are common and usually asymptomatic. Left gastric artery variations are very rare and awareness of such anatomical variations has become specifically important in patients undergoing hepatobiliary surgeries and liver transplantation to avoid serious ischemic complications. Therefore, it was aimed to study the coeliac trunk and its branching pattern. Objective: The present study is aimed to investigate anatomical variations of the coeliac trunk and left gastric artery. Methods: The present study was carried out on 42 cadavers of age 60-80 years who were allotted to 1st year MBBS students for routine dissection during the period of last 4 years in Department of Anatomy, AIIMS, New Delhi. Dissection was done to identify the coeliac trunk and its branches. The branches were traced from origin to termination. Results: We observed three unusual variations in arterial patterns of the coeliac trunk in 42 cadavers. The middle colic artery was arising from coeliac trunk which was supplying the uncinate process of pancreas and transverse colon. In another two cases we observed an accessory branch arising from left gastric artery which was supplying the left lobe of liver and cardiac end of stomach. Conclusion: The knowledge of deviations from the normal arterial pattern of gastrointestinal tract is of immense significance for surgical and radiological procedures pertaining to the liver and adjacent viscera.