VARIANT ANATOMY OF THE CELIAC TRUNK, ITS MAIN AND ABERRANT BRANCHES



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Abstract

Objective - with the use of postvital and intravital methods of investigation, to study the patterns of branching and morphometric characteristics of the celiac trunk, its main branches and aberrant arteries, the most significant atypical variants and frequency of their occurrence. Material and methods. The results of multi-phase spiral computed tomography angiography of 100 patients, digital subtraction angiography of 100 patients were retrospectively analyzed, cadaveric material of adults (76 objects), 16 corrosion preparations were studied, a total of 292 observations. The level of deviation of the celiac trunk from the abdominal part of the aorta, the morphometric characteristics of the celiac trunk and its branches, the branching pattern and frequency of typical and atypical variants of branching of the celiac trunk and its main branches, their aberrant arteries were estimated. Results. In most cases, the celiac trunk arose at the level of the intervertebral discs TXII-LI (76 %), with a range from TXII to LII. The length and diameter of the celiac trunk and its branches were characterized by a wide range of differences between the minimum and maximum values. In 83 % of the observations, the celiac trunk had a typical pattern of trifurcation, atypical variants were represented by bifurcation (14.7 %), quadrifurcation (1.3 %), pentafurcation (0.3 %), absence of trunk (0.3 %), as well as various variants of branching with the presence of aberrant arteries (9 %). Multiphase spiral computed tomography angiography and digital subtraction angiography demonstrated high intravital efficiency in displaying various branching patterns of the celiac trunk and its branches. The knowledge of anatomical variants helps to plan the operation at the preoperative stage, and can reduce the incidence of complications and risk of iatrogenic lesions during surgical intervention. Conclusions. The celiac trunk and its branches have a wide range of variant anatomy concerning its topography, branching pattern and the presence of aberrant arteries.

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About the authors

I. V. Gaivoronskiy

S. M. Kirov Military Medical Academy; St. Petersburg State University

Email: giv_anatom@yandex.ru
Department of Normal Anatomy, Department of Hospital Surgery; Department of Morphology 7-9 Universitetskaya emb., St. Petersburg, 199034

B. N. Kotiv

S. M. Kirov Military Medical Academy

Department of Normal Anatomy, Department of Hospital Surgery

N. A. Kovalenko

S. M. Kirov Military Medical Academy

Department of Normal Anatomy, Department of Hospital Surgery

Yu. V. Pelipas

N. N. Petrov National Medical Research Center of Oncology

Scientific Department of Gastrointestinal Tract Tumors 68 Leningradskaya Str., St. Petersburg 197758

I. A. Goryacheva

S. M. Kirov Military Medical Academy

Department of Normal Anatomy, Department of Hospital Surgery

O. M. Fandeyeva

S. M. Kirov Military Medical Academy

Department of Normal Anatomy, Department of Hospital Surgery

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