celiac trunk

The celiac artery, also known as the celiac axis or celiac trunk, is a major visceral artery in the abdominal cavity supplying the foregut. It arises from the abdominal aorta and commonly gives rise to three branches: left gastric artery, splenic artery, and common hepatic artery.

Gross anatomy

Origin

Arises anteriorly from abdominal aorta just below diaphragm at the T12 level, behind the median arcuate ligament, just as the aorta enters the abdomen in between right and left crura.

Course

It is typically a short vessel that passes underneath the median arcuate ligament, often indented on its superior surface by this ligament, and then courses anteriorly or slightly anterolaterally in the lesser sac. It is surrounded by celiac lymph nodes and the celiac plexus. At the upper border of the pancreas, it divides into three branches: left gastric, splenic, and common hepatic arteries. The left gastric artery is usually the first branch, after which the celiac artery bifurcates into the splenic artery (coursing to the left) and the common hepatic artery (coursing to the right).

Branches

• left gastric artery
• splenic artery
• common hepatic artery

Branching patterns

• common trunk with bifurcation into the hepatosplenic trunk and left gastric artery: 50-76%
• common trunk with trifurcation into the common hepatic artery, splenic artery and left gastric artery: 10-19%
• quadrifurcating or pentafurcating trunk with the gastroduodenal artery, right and left hepatic arteries and dorsal pancreatic artery potentially originating from the trunk: 10% 

Supply

The celiac artery supplies the foregut, which is defined by the following structures :

• gut from the distal oesophagus to the ampulla of Vater of 2 part of the duodenum
• liver
• gallbladder and biliary tree
• spleen
• pancreas
• greater omentum
• lesser omentum

Variant anatomy

Classic branching of the celiac artery into the left gastric artery, splenic artery, and the common hepatic artery is seen in approximately 70%. Variations are present in approximately 30%. In general, any of the three celiac branches may arise independently from the aorta or SMA, or the celiac artery may give rise to other branches. A celiacomesenteric trunk occurs when both the SMA and the celiac trunk originate as a single trunk from the aorta.

Extra-celiac origin of its three branches

From aorta

• left gastric artery: 2-3%
• splenic artery: <1%
• common hepatic artery: 2%

From SMA

• left gastric artery: extremely rare
• splenic artery: <1%
• common hepatic artery: 2%

Other branches that may arise directly from the celiac artery

• dorsal pancreatic artery
• right hepatic artery                                   
• gastroduodenal artery
• inferior phrenic arteries

Variant origin 

• common origin of the celiac artery and SMA (celiacomesenteric trunk): <1%

There is also a plethora of variations in the branching of the second and third-order branches of the celiac artery, particularly hepatic arterial anatomy which is discussed with the common hepatic artery.

Related pathology

• celiac artery compression syndrome
• celiac artery dissection
• celiac artery aneurysm
• upper GI bleeding

Siehe auch:

• Truncus-coeliacus-Kompressionssyndrom
• Aorta abdominalis
• Arteria lienalis
• obere gastrointestinale Blutung
• Arteria hepatica communis
• Arteria gastrica sinistra

und weiter:

• Truncus coeliacus Varianten
• Zöliakusblockade
• arc of Buhler
• Varianten der Arteria mesenterica superior
• Varianten der arteriellen Leberversorgung
• Viszeralarterien
• collateral systems between the celiac trunk and superior mesenteric artery
• TNM Staging Pankreaskarzinom
• celiac trunk aneurysm