Desenvolvimento incomum do tronco celíaco e sua importância clínica

Apresentamos um relato de caso de desenvolvimento incomum do tronco celíaco em um cadáver do sexo masculino de 1 ano de idade. O tronco celíaco ramificou-se para cinco vasos: as artérias esplênica, hepática comum e gástrica esquerda, a artéria diafragmática inferior esquerda e um tronco pequeno que se ramificou para a artéria diafragmática inferior direita e para a artéria hepática direita acessória. Além disso, a forma como o vaso se ramificou foi incomum: é possível distinguir dois pontos de ramificação que correspondem à trajetória em formato de S. Também houve outras variações do suprimento vascular, como a presença da artéria hepática esquerda acessória, da artéria pancreaticoduodenal superior acessória e outras. Cabe observar que a variação de desenvolvimento múltipla pode ser comum na prática clínica, e os médicos devem estar cientes dela durante os procedimentos de diagnóstico e intervenção.

Palavras-chave:
tronco celíaco; artéria hepática esquerda acessória; artéria hepática direita acessória; artéria pancreaticoduodenal superior acessória

Autoria

Serghei Covantev

State University of Medicine and Pharmacy “Nicolae Testemitanu”, Laboratory of Allergology and Clinical Immunology, Chişinau, Republic of Moldova.State University of Medicine and Pharmacy “Nicolae Testemitanu”Republic of MoldovaChişinau, Republic of MoldovaState University of Medicine and Pharmacy “Nicolae Testemitanu”, Laboratory of Allergology and Clinical Immunology, Chişinau, Republic of Moldova.

http://orcid.org/0000-0001-7236-5699

Natalia Mazuruc

State University of Medicine and Pharmacy “Nicolae Testemitanu”, Department of Human Anatomy, Chişinau, Republic of Moldova.State University of Medicine and Pharmacy “Nicolae Testemitanu”Republic of MoldovaChişinau, Republic of MoldovaState University of Medicine and Pharmacy “Nicolae Testemitanu”, Department of Human Anatomy, Chişinau, Republic of Moldova.

Irina Drangoi

Olga Belic

Conflicts of interest: No conflicts of interest declared concerning the publication of this article.

Correspondence Serghei Covantev State University of Medicine and Pharmacy “Nicolae Testemitanu”, Laboratory of Allergology and Clinical Immunology Stefan cel Mare si Sfant Boulevard 165, Bd. MD-2004 2005 - Chişinau, Republic of Moldova Tel.: +373 69019868 E-mail: kovantsev.s.d@gmail.com

Author information SC - MD; BEc, Laboratory of Allergology and Clinical Immunology, State University of Medicine and Pharmacy “Nicolae Testemitanu”. NM - MD student, Department of Human Anatomy, State University of Medicine and Pharmacy “Nicolae Testemitanu”. ID - MD; Lecturer, Department of Human Anatomy, State University of Medicine and Pharmacy “Nicolae Testemitanu”. OB - MD; PhD; Associate Professor, Department of Human Anatomy, State University of Medicine and Pharmacy “Nicolae Testemitanu”.

Author contributions Conception and design: SC, NM, ID, OB Analysis and interpretation: SC, NM, Data collection: SC, NM, ID Writing the article: SC, NM, ID, OB Critical revision of the article: SC, OB Final approval of the article: SC, NM, ID, OB Statistical analysis: N/A. Overall responsibility: SC, NM, ID, OB *All authors have read and approved of the final version of the article submitted to J Vasc Bras.

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Figuras

Figuras (5)

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Figure 1
Anatomy of the celiac trunk. (1) common bile duct; (2) proper hepatic artery; (3) portal vein; (4) inferior vena cava; (5) accessory right hepatic artery; (6) right inferior diaphragmatic artery; (7) abdominal aorta; (8) left gastric artery; (9) left accessory liver artery; (10) the diaphragm; (11) the caudate lobe of the liver; (12) arteries of the lesser curvature of the stomach; (13) stomach; (14) the inferior diaphragmatic artery; (15) splenic artery; (16) celiac trunk; (17) additional superior pancreatoduodenal artery; (18) common hepatic artery; (19) gastroduodenal artery; (20) pancreas; (21) duodenum.

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Figure 2
Schematic representation of the celiac trunk. (1) right inferior diaphragmatic artery; (2) right accessory hepatic artery; (3) common hepatic artery; (4) left gastric artery; (5) splenic artery; (6) celiac trunk; (7) left inferior diaphragmatic artery. A = aorta.

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Figure 3
Vascular supply to the organs of the upper abdominal cavity. (1) common hepatic artery; (2) additional superior pancreatoduodenal artery; (3) proper hepatic artery; (4) gastroduodenal artery; (5) superior pancreatoduodenal artery; (6) common trunk; (7) the inferior artery of the pancreatic head; (8) right gastro-epiploic artery; (9) the stomach; (10) pancreas; (11) common bile duct; (12) portal vein; (13) the liver; (14) right accessory hepatic artery; (15) left accessory hepatic artery; (16) arteries to the lesser curvature of the stomach; (17) abdominal aorta; (18) left gastric artery; (19) splenic artery; (20) branch to the wall of the duodenal ampulla.

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Figure 4
The branches of the celiac trunk (stomach raised up). (1) spleen; (2) splenic artery; (3) pancreas; (4) right kidney; (5) left adrenal gland; (6) the left gastroepiploic artery; (7) abdominal aorta; (8) celiac trunk; (9) common hepatic artery; (10) additional superior pancreatoduodenal artery; (11) inferior vena cava; (12) left accessory hepatic artery; (13) right inferior diaphragmatic artery; (14) gastric left artery; (15) left inferior diaphragmatic artery; (16) superior adrenal artery; (17) the stomach; (18) the liver.

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Figure 5
Schematic representation of vascular supply from the celiac trunk.

Figure 1 Anatomy of the celiac trunk. (1) common bile duct; (2) proper hepatic artery; (3) portal vein; (4) inferior vena cava; (5) accessory right hepatic artery; (6) right inferior diaphragmatic artery; (7) abdominal aorta; (8) left gastric artery; (9) left accessory liver artery; (10) the diaphragm; (11) the caudate lobe of the liver; (12) arteries of the lesser curvature of the stomach; (13) stomach; (14) the inferior diaphragmatic artery; (15) splenic artery; (16) celiac trunk; (17) additional superior pancreatoduodenal artery; (18) common hepatic artery; (19) gastroduodenal artery; (20) pancreas; (21) duodenum.

Figure 2 Schematic representation of the celiac trunk. (1) right inferior diaphragmatic artery; (2) right accessory hepatic artery; (3) common hepatic artery; (4) left gastric artery; (5) splenic artery; (6) celiac trunk; (7) left inferior diaphragmatic artery. A = aorta.

Figure 3 Vascular supply to the organs of the upper abdominal cavity. (1) common hepatic artery; (2) additional superior pancreatoduodenal artery; (3) proper hepatic artery; (4) gastroduodenal artery; (5) superior pancreatoduodenal artery; (6) common trunk; (7) the inferior artery of the pancreatic head; (8) right gastro-epiploic artery; (9) the stomach; (10) pancreas; (11) common bile duct; (12) portal vein; (13) the liver; (14) right accessory hepatic artery; (15) left accessory hepatic artery; (16) arteries to the lesser curvature of the stomach; (17) abdominal aorta; (18) left gastric artery; (19) splenic artery; (20) branch to the wall of the duodenal ampulla.

Figure 4 The branches of the celiac trunk (stomach raised up). (1) spleen; (2) splenic artery; (3) pancreas; (4) right kidney; (5) left adrenal gland; (6) the left gastroepiploic artery; (7) abdominal aorta; (8) celiac trunk; (9) common hepatic artery; (10) additional superior pancreatoduodenal artery; (11) inferior vena cava; (12) left accessory hepatic artery; (13) right inferior diaphragmatic artery; (14) gastric left artery; (15) left inferior diaphragmatic artery; (16) superior adrenal artery; (17) the stomach; (18) the liver.

Figure 5 Schematic representation of vascular supply from the celiac trunk.

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Desenvolvimento incomum do tronco celíaco e sua importância clínica

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[1] Conflicts of interest: No conflicts of interest declared concerning the publication of this article.