Case Report of International Journal of Case Reports
A rare branching pattern of the celiac trunk associated with an accessory aberrant cystic duct
Maryna Kornieieva1 and Chase Doiron2
1PhD, MD, Anatomy, Histology, and Embryology Department AUC School of Medicine, Lowlands, Sint Maarten;
21st year student of the AUC School of Medicine, Lowlands, Sint Maarten
During routine educational dissection of the upper part of the abdominal cavity in a female cadaver (67 years old, Netherlands) a unique association of two rare biliary and vascular patterns was discovered.
The gastroduodenal artery originated from the celiac trunk along with the right hepatic, gastric and splenic arteries, and gave origin to the accessory right and left hepatic vessels. The right hepatic artery took the course typical for the common hepatic artery; however, as a component of the portal triad, the artery was located behind the bile duct and portal vein. Next to the hilum of the liver, it branched off the cystic artery to the gallbladder and bifurcated into two segmental hepatic branches. The described hepatic vascular pattern was associated with the presence of an accessory aberrant cystic duct connecting the body of the gallbladder with the right anterior inferior segmental bile duct.
The case is reported to emphasize the importance of a detailed preoperative investigation of the patients considered for open and laparoscopic procedures on the liver and gallbladder documenting the variability of both the biliary and vascular patterns.
Keywords: gastroduodenal artery, celiac trunk variability, accessory retroportal right hepatic artery, aberrant accessory cystic duct.
How to cite this article:
Maryna Kornieieva and Chase Doiron. A rare branching pattern of the celiac trunk associated with an accessory aberrant cystic duct International Journal of Case Reports, 2019 4:88. DOI: 10.28933/ijcr-2019-07-2905
1. Aristotle S, Jebakani C. A duplication of the cystic duct – case report: Eur J Anat. 2011; 15 (3): 176-178.
2. Chitra R. Clinical relevance of a rare variation in the origin of gastroduodenal artery: International Journal of Anatomical Variations. 2009; 2: 69–70.
3. Favelier S, Germaina T, Gensona P, Cercueil J, Denys A, Krause D, et al. Anatomy of liver arteries for interventional radiology: Diagnostic and Interventional Imaging. 2015; 96: 537—546.
4. Fujii A, Hiraki M, Egawaa N, Kono H, Ide T, Nojiri J, et al. Double cystic duct preoperatively diagnosed and successfully treated with laparoscopic cholecystectomy: A case report: International Journal of Surgery Case Reports. 2017; 37: 102–105.
5. Fujikawa T, Takeda H, Matsusue S, Nakamura Y, Nishimura S. Anomalous Duplicated Cystic Duct as a Surgical Hazard: Report of a Case: Surgery Today. 1998; 28: 313–315.
6. Herpers R. Genetic regulation of vascular development. 2010; Royal Netherlands Academy of Art and Sciences (KNAW), Rotterdam, Netherlands.
7. Joleya M, Suryavanshi S, Sharma D. Variations in Origin of Gastroduodenal Artery: A Cadaveric Study: IJSS Journal of Surgery. 2016; 2(3): 6-9.
8. Lamah M, Dickson G. Congenital anatomical abnormalities of the extrahepatic biliary duct: a personal audit: Surg RadioI Anat. 1999; 21: 325-327.
9. Lipshutz B. A composite study of the coeliac axis artery: Ann Surg. 1917; 65: 159-69. 10. Michels N. Newer anatomy of the liver and its variant blood supply and collateral circulation: Am J Surg. 1966; 112(3): 337—47.
10. Natsis K, Piagkou M, Stamatopoulos T, Spyridakis I, Apostolidis S. Anastomotic loop
11. between common hepatic artery and gastroduodenal artery in coexistence with an aberrant right hepatic artery: Folia Morphol. 2017; 76(4): 752–756.
12. Neto S, Franca H, Mello C, Neto E, Negromonte G, Duarte C, et al. Anatomical variations of the celiac trunk and hepatic arterial system: an analysis using multidetector computed tomography angiography: Radiol Bras. 2015; 48(6): 358–362.
13. Sarawagi R, Sundar S, Gupta K, Raghuwanshi S. Anatomical Variations of Cystic Ducts in Magnetic Resonance Cholangiopancreatography and Clinical Implications: Hindawi Publishing Corporation Radiology Research and Practice. 2016; 1: 1-6; (Published online 24 March 2016; http://dx.doi.org/10.1155/2016/3021484).
14. Sarin Y. Biliary ductal and vascular anomalies associated with choledochal cyst: J. Indian Assoc Pediatr Surg. 2005; 10(2): 86-88.
15. Strazzabosco M, Fabris L. Development of the Bile Ducts: Essentials for the Clinical Hepatologist: J Hepatol. 2012; 56(5): 1159–1170.
16. Walker T. Mesenteric Vasculature and Collateral Pathways: Seminars in Interventional Radiology. 2009; 26(3): 167-174.
17. Yamashita K, Hashimoto D, Itoyama R, Okabe H, Chikamoto A, Beppa T, et al. Accessory right hepatic artery branched from gastroduodenal artery: Surgical Case Reports. 2015; 1: 90. Published online 28 September 2015; DOI 10.1186/s40792-015-0092-7.