Surgical and Radiologic Anatomy

, Volume 29, Issue 3, pp 269–271 | Cite as

Anomalous hepatic arterial anatomy discovered during pancreaticoduodenectomy

  • Jonathan A. Adamthwaite
  • Neil Pennington
  • Krishna V. Menon
Anatomic Variations
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Abstract

Introduction

A number of variations in hepatic arterial anatomy have been described. Anomalous arterial supply is of particular relevance to the hepatobiliary, pancreatic or liver transplant surgeon.

Case report

We describe the case of a 57-year-old gentleman who presented with painless obstructive jaundice and was found to have a mass in the head of the pancreas. At pylorus-preserving pancreaticoduodenectomy a distal quadrifurcation of the hepatic artery was discovered. It gave rise to the right hepatic artery, left hepatic artery, intermediate branch and a right accessory hepatic artery. The right accessory hepatic artery gave rise to the gastroduodenal artery.

Conclusion

The surgeon and interventional radiologist need to be aware of the potential for such aberrant anatomy in order to avoid potentially disastrous complications.

Keywords

Hepatic artery Variation Accessory hepatic artery Anatomy 
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References

  1. 1.
    Abdullah SS, Mabrut JY, Garbit V, De La Roche E, Olagne E, Rode A, Morin A, Berthezene Y, Baulieux J, Ducerf C (2006) Anatomical variations of the hepatic artery: study of 932 cases in liver transplantation. Surg Radiol Anat 28(5):468–473PubMedCrossRefGoogle Scholar
  2. 2.
    Arnold MM, Kreel L, Lo YF, Law H (1991) Are the hepatic arteries “end arteries”? Invest Radiol 26:337–342PubMedCrossRefGoogle Scholar
  3. 3.
    Covey AM, Brody LA, Maluccio MA, Getrajdman GI, Brown KT (2002) Variant hepatic arterial anatomy revisited: digital subtraction angiography performed in 600 patients. Radiology 224:542–7PubMedGoogle Scholar
  4. 4.
    De Santis M, Ariosi P, Calo GF, Romagnoli R (2000) Hepatic arterial vascular anatomy and its variants. Radiol Med (Torino) 100:145–51Google Scholar
  5. 5.
    Gruttadauria S, Foglieni CS, Doria C, Luca A, Lauro A, Marino IR (2001) The hepatic artery in liver transplantation and surgery: vascular anomalies in 701 cases. Clin Transplant 15:359–64PubMedCrossRefGoogle Scholar
  6. 6.
    Jones RM, Hardy KJ (2001) The hepatic artery: a reminder of surgical anatomy. J R Coll Surg Edinb 46:168–170PubMedGoogle Scholar
  7. 7.
    Michels NA (1955) Blood supply and anatomy of the upper abdominal organs, with descriptive atlas. JB Lippincott Co., Philadelphia, pp 139–163Google Scholar
  8. 8.
    Michels NA (1966) Newer anatomy of the liver and its variant blood supply and collateral circulation. Am J Surg 112:337–347PubMedCrossRefGoogle Scholar
  9. 9.
    Peschaud F, El Hajjam M, Malafosse R, Goere D, Benoist S, Penna C, Nordlinger B (2006) A common hepatic artery passing in front of the portal vein. Surg Radiol Anat 28(2):202–205PubMedCrossRefGoogle Scholar
  10. 10.
    Voboyril R, Weberova J, Dvorak J (2002) Anomalies in liver arterial blood supply and their importance for hepatic surgery. Acta Medica (Hradec Kralove) 45:39–44Google Scholar
  11. 11.
    Volpe CM, Peterson S, Hoover EL, Doerr RJ (1998) Justification for visceral angiography prior to pancreaticoduodenectomy. Am Surg 64:758–61PubMedGoogle Scholar
  12. 12.
    Weiglein AH (1996) Variations and topography of the arteries in the lesser omentum in humans. Clin Anat 9:143–150PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Jonathan A. Adamthwaite
    • 1
  • Neil Pennington
    • 1
  • Krishna V. Menon
    • 1
  1. 1.Department of SurgerySt James’s University HospitalLeedsUK

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