Rare variation of the branches of the coeliac trunk and the common hepatic artery in human cadaver: a case report.

BACKGROUND

The liver with its dual blood supply from the portal vein and the common hepatic artery (CHA) is unique among parenchymal organs. CHA accounts for around 30% of blood flow to the liver but has a central role in hepatobiliary perfusion.

CASE PRESENTATION: We demonstrated a rare case of unusual branching of the CHA during routine dissection of an embalmed female cadaver. Measurements of the diameter and distance of origin of the branches were performed. The coeliac trunk presented with five branches - left gastric, splenic, CHA, right inferior phrenic, and accessory left hepatic arteries. The CHA pentafurcated into the left hepatic (LHA), middle hepatic (MHA), right hepatic (RHA), cystic (CA), right gastric (RGA), and gastroduodenal arteries (GDA). The first branch presented was RGA to the lesser curvature of the stomach. Instead of proper hepatic artery, three branches were observed - LHA, MHA, and posteriorly and between them, RHA. Inferiorly the GDA, with its diameter of 4 mm, represented a direct continuation of CHA. Accessory RHA artery was also identified branching from superior mesenteric artery.

DISCUSSION: Variations of the hepatic arterial blood supply are seen in more than half of the population. The described variations were not previously identified according to the available literature.

CONCLUSION

Such complex variation, as the one presented in the current case, represents significant deviation from the norm. In the past, they were considered anatomical curiosities but now, in the era of complex liver surgeries and arterial-directed therapies, their relevance is being highly recognized.