Abstract
Aim: To determine the comprehensive spectrum of celiac axis including SMA, IMA, hepatic and renal artery variations with the use of multi-detector computed tomography (MDCT).
Material and Methods: This retrospective and prospective study was conducted in the Department of Radio diagnosis, Dr. S.N. Medical College and Associated Group of Hospitals, Jodhpur in 500 patients subjected to MDCT abdomen for various indications. Patients with a history of prior major upper abdominal surgery and patients with occlusion of celiac, hepatic, SMA and renal arteries were excluded.
Results: Seven types of celiac axis anatomic variations were identified in our study (including SMA). Anatomic variations in celiac axis were seen in 9% of patients with ambiguous celiac axis anatomy in 2% of the patients. IMA origin was normal in all patients. CHA originated from celiac axis in 95.20% of the patients. Variations in anatomic origin of CHA were seen in 2.8% patients. Normal origin of RHA from HAP and CHA was seen in 77.75% patients. LHA originated from HAP and CHA in 77.75% patients. MHA originated from RHA in 48% patients, LHA in 12% and from CHA in 12% cases. Origin of MHA could not be defined in 28% of patients. GDA originated from CHA in 95% of patients. Single renal artery was seen in 53% patients. 49% patient have variation in the form of early branching and additional renal arteries.
Conclusion: Variations in the celiac trunk, SMA, hepatic artery and renal artery are common, and their detection is important prior to any interventions or abdominal surgeries.
Keywords: SMA/IMA-superior/inferior mesenteric artery; CHA- common hepatic artery; HAP-hepatic artery proper; RHA/LHA/MHA- right/left/middle hepatic artery; GDA-gastro duodenal artery.
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Corresponding Author
Chouhan Ajay Singh
Resident, Dr. S. N. Medical College and Attached Group of Hospitals, Jodhpur, India