Two Variants in One: Celiomesenteric Trunk with a Proximal SMA-originated Trunk with a Retrograde Hepatic Artery.

PURPOSE: This case report describes an asymptomatic 23-year-old male volunteer in whom an incidental celiomesenteric trunk (CMT) with an associated aberrant retrograde hepatic artery arising from the proximal superior mesenteric artery (SMA) was identified during an educational ultrasound session.

METHODS

High-resolution ultrasonography with color Doppler was used to visualise the abdominal aorta and its visceral branches in both sagittal and transverse planes.

RESULTS

Imaging demonstrated a single common trunk originating from the anterior abdominal aorta, which bifurcated into the celiac trunk and SMA. Additionally, a distinct arterial branch arose from the proximal SMA and coursed superiorly toward the porta hepatis, consistent with a replaced right hepatic artery following a retrograde trajectory.

CONCLUSION

This combination of a CMT and a retrograde replaced right hepatic artery from the proximal SMA represents an uncommon anatomical configuration with direct implications for complex aortic debranching procedures, mesenteric revascularisation, and hepatopancreatobiliary surgery. The case also illustrates the educational value of point-of-care ultrasound in revealing anatomical variations beyond the classic textbook description.