Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Abdomen
Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD
Peer Review Status: Internally Peer Reviewed
Variations in the abdominal aorta are not common. According to Quain, in 10 out of every 13 (about 80%) subjects examined, the bifurcation of the aorta occurred within 1.2 cm (~0.5 in) above or below the level of the highest point of the iliac crest, more frequently below the crest than above it. The most common place for its bifurcation, which is opposite the lower border of the body of the fourth lumbar vertebra, but it may divide opposite the disc between L4 and L5 or rarely opposite the body of the fifth lumbar vertebra. Bifurcation of the abdominal aorta occurs in about 75% of cases at this level. A higher division is less common (9%) than a lower division (11%). The artery has been found, however, dividing as high as the origin of the renal arteries, or even as high as the second lumbar vertebra.
The following rare variations of the abdominal aorta have been described:
1) The aorta may pass through the esophageal hiatus (opening) of the diaphragm.
2) It may lie on the right side of the vena cava, the vein passing over the upper part of the aorta to gain access to the caval hiatus.
3) The aorta may have a vena cava on each side, the left vein passing across the upper part of the artery to open into the right vein just below the caval opening.
In some cases the aorta gives rise to a pulmonary branch close to the origin of the celiac artery; the unusual vessel then passes through the esophageal opening and supplies a branch to the lower lobe of each lung.
The aorta may run to the right of the inferior vena cava.
Direct branches of the abdominal aorta sometimes include an accessory inferior phrenic, splenic, hepatic, accessory hepatic, supreme pancreatic, accessory superior mesenteric, inferior suprarenals, accessory gonadal, accessory and fifth lumbar, internal iliac, umbilical, and/or accessory median sacral.
The aorta may have a marked sinuous course throughout the abdomen.
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Variations in the Branches of the Abdominal Aorta
The following variations have been recorded in the branches of the abdominal aorta.
Inferior Phrenic Artery
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