Abstract
The left gastroepiploic artery (LGEA) is the least described artery in the medical literature. Unusual variations of this artery might lead to vascular injuries, causing intraoperative bleeding after surgery. We observed rare vascular variations in an adult male cadaver. The left gastroepiploic artery after its origin from splenic artery pierced the pancreatic parenchyma at its posterior surface. After a short intrapancreatic course, the LGEA emerged out from the superior border of the body of the pancreas. LGEA then trifurcated into an omental branch, duplicated LGEA and another branch that continued as the main trunk of LGEA. Main LGEA and duplicated LGEA coursed towards the greater curvature of the stomach. The main LGEA ended by anastomosing with the right gastroepiploic artery, while the duplicated LGEA ended at the greater curvature of the stomach by ramifying into minute branches on the walls of the stomach and gave few gastric branches to supply the stomach and also supplied the greater omentum. This variation was associated with the presence of an accessory splenic artery. Anatomists, surgeons, and radiologists should be aware of such anomalous vascular variations as it could help to minimize complications related to pancreatectomy, omentoplasty, and resection of pancreatic tumors.
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References
Egorov VI, Yashina NI, Zhurenkova TV, Petukhova MV, Starostina NS, Zarinskaya SA, Dmitriyeva KA, Shevchenko TV, Petrov RV (2011) Spleen-preserving distal pancreatectomy with resection of the splenic vessels. Should one rely on the short gastric arteries? JOP 12(5):445–457
Eshuis WJ, Olde Loohuis KM, Busch ORC, van Gulik TM, Gouma DJ (2011) Influence of aberrant right hepatic artery on perioperative course and long-term survival after pancreatoduodenectomy. HPB 13:161–167
Hamilton WJ, Mossman HW (1976) Alimentary and respiratory system, pleural and peritoneal cavities. In: Hamilton, Boyd and Mossman’s human embryology, 4th edn. Macmillan Press, London, pp 291–376
Hultman CS, Carlson GW, Losken A et al (2002) Utility of the omentum in the reconstruction of complex extraperitoneal wounds and defects: donor-site complications in 135 patients from 1975 to 2000. Ann Surg 235(6):782–795
Michels NA (1942) The variational anatomy of the spleen and splenic artery. Am J Anat 70:21–72
Michels NA (1955) Blood supply and anatomy of the upper abdominal organs with a descriptive atlas. Lippincott, Philadelphia, pp 208–210
Naga JD, Ramani TV, Saritha S, Gayathri P, Sadananda RB, Anjum A (2015) Cadaveric study of variations in branching pattern of splenic artery. Int J Anat Res 3(4):1629–1634
Ozan H, Onderoglu S (1997) Intrapancreatic course of the splenic artery with combined pancreatic anomalies. Surg Radiol Anat 19:409–411
Standring S (2005) Gray’s anatomy—the anatomical basis of clinical practice, 39th edn. Elsevier/Churchill Livingstone, Edinburg, p 606
Tomioka K, Murakami M, Saito A, Ezure H, Moriyama H, Mori R, Otsuka N (2016) Anatomical and surgical evaluation of gastroepiploic artery. Okajimas Folia Anat Jpn 92(3–4):49–52
Zeon SK, Kim SG, Huyn JA, Kim Y-S (1998) Angiographic branching patterns of the splenic artery. Int J Angiol 7(1):57–61
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We wish to acknowledge Mr. Ganesh N. Prasad, Artist, KMC Manipal for the schematic diagram used in this report.
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Kumar, N., Aithal, A.P. & Guru, A. Unusual duplication and vulnerable intrapancreatic course of the left gastroepiploic artery: a rare anatomical variation. Surg Radiol Anat 41, 351–353 (2019). https://doi.org/10.1007/s00276-019-02188-w
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DOI: https://doi.org/10.1007/s00276-019-02188-w