Anatomical variations of the celiac trunk: cadaveric and radiological study.
OBJECTIVE
The celiac trunk (CT) is a vascular structure of the upper abdomen which gives off the left gastric artery (LGA), the splenic artery and the common hepatic artery. This study aims to compare the vascular patterns of the CT of two different samples (cadaveric and radiological) and to propose a simple classification of CT variations based on previous studies and our results.


METHODS
To perform this study we examined 43 adult cadavers, 24 males and 19 females, ages ranged from 69 to 92. In addition, we analysed 596 MDCT (multidetector computed tomographic) angiography examinations of 430 males and 166 females, ages ranged from 42 to 82.


RESULTS
According to the classification proposed, results were divided into Type I or complete CT (578/639 cases, 90.5 %), Type II or incomplete CT (61/639 cases, 9.5 %), Type III or absence of CT and Type IV or celiacomesenteric trunk with no cases reported. Type I was divided into Type Ia or bifurcated trunk with LGA arising first (368/639 cases, 57.6 %), Type Ib or trifurcated trunk (205/639 cases, 32.1 %) and Type Ic or tetrafurcated trunk with an extra branch (5/639 cases, 0.8 %). Type II included hepatosplenic (29/639 cases, 4.5 %), gastroplenic (32/639, 5 %) and hepatogastric trunks (0/639, 0 %) which represented Types IIa, IIb and IIc respectively.


CONCLUSIONS
No significant differences were found between the cadaveric and radiological samples. Gender did not appear to be related to any variability of the structures either. A new, simple and complete classification of the anatomical variations of the CT is proposed.
Department of Anatomy, Faculty of Medicine, Complutense University, Madrid, Spain.
I
I
Marco-Clement
Department of Anatomy, Faculty of Medicine, Complutense University, Madrid, Spain. alejandrambarco@gmail.com.
A
A
Martinez-Barco
Department of Radiology, Clinico San Carlos Hospital, Madrid, Spain.
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N
Ahumada
Department of Computer Sciences and Statistics, Rey Juan Carlos University, Madrid, Spain.
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C
Simon
Department of Anatomy, Faculty of Medicine, Complutense University, Madrid, Spain.
J M
JM
Valderrama
Department of Anatomy, Faculty of Medicine, Complutense University, Madrid, Spain.
J
J
Sanudo
Department of Radiology, Clinico San Carlos Hospital, Madrid, Spain.
J
J
Arrazola
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D063405:Anatomic Variation; D002445:Celiac Artery / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D000072226:Computed Tomography Angiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography
Abdominal surgery; Anatomy; CT angiography; Celiac trunk; Tripod; Variations