Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Abdomen: Variations in Branches of Celiac Trunk
Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD
Peer Review Status: Internally Peer Reviewed
There may be two left gastric arteries instead of one.
The left gastric sometimes provides an enlarged (accessory) branch (8-25% of individuals) or sometimes it replaces the left hepatic artery (11-12% of individuals).
Poynter refers to the Vesalian view that the left gastric usually arises as a branch of the splenic; this was corrected by Winslow in 1832. Is it possible that this was a "chance" observation by Vesalius, who turned his attention elsewhere, and believed this relationship was the usual condition? The present authors do not know of another such reference.
According to Poynter, numerous reports have been given of this vessel associated with the hepatic or an accessory hepatic.
The branches of the left gastric artery are esophageal and hepatic. The esophageal arteries anastomose with other esophageal arteries from the aorta, and with bronchial, posterior intercostal, and phrenic arteries. The hepatic branch (aberrant hepatic) occurs in 25% of individuals (Michels, 1955; in 18.2% according to Moosman et al.) This artery may provide additional cardioesophageal branches. In about half of its occurrences the artery is the left hepatic; in the other half it is a replacing hepatic.
Image 255A, Image 343
Anson, B.J., Ed. (1966) Morris' Human Anatomy, 12ed., McGraw-Hill Book Company, New York.
Barlow, T.E., Bentley, F.H. and D.N. Walder. (1951) Arteries and veins and arteriovenous anastomoses in the human stomach. Surg., Gynecol. Obstet. 93:657-671.
Bergman, R.A., Thompson, S.A., Afifi, A.K. and F.A. Saadeh. (1988) Compendium of Human Anatomic Variation: Catalog, Atlas and World Literature. Urban & Schwarzenberg, Baltimore and Munich.
Chadzypanagiotis, D. and L. Amerski. (1978) A rare case of the celiac trunk anomaly. Folia Morphol., Warsaw 37:401-405.
Kostinovitch, L.I. (1937) A case of simultaneous occurrence of a number of variations of the visceral branches of the abdominal aorta. Anat. Rec. 67:399-403.
Leriche, R. and F. Villemin (1906) Le rameau hepatique de l'artère coronaire stomachique. Soc. Biol. Comptes Rendus Hebdomadaires des Séances et memoires. 61:721-722.
Lipshutz, B. (1917) A composite study of the coelic axis artery. Ann. Surg. 65:159-169.
Poynter, C.W.M. (1922) Congenital anomalies of the arteries and veins of the human body with bibliography. The University Studies of the University of Nebraska 22:1-106.
Swigart, LaV.L., Siekert, R.G., Hambley, W.C. and B.J. Anson. (1950) The esophageal arteries. An anatomic study of 150 specimens. Surg., Gynecol. Obstet. 90:234243.
Walsham, W.J. (1881) Anatomical variations: Left lobe of the liver supplied by a branch of the gastric artery. Saint Bartholomews Hospital Reports 17:77-78.
Winslow, -. (1832) Exposition Anatomique de la Structure du Corps Humaine, cited from Poynter, 1922.
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