Anomalous celiac trunk associated with accessory spleens and variant renal and inferior phrenic vessels: case report and brief review.

Abstract

Background: Identification of anatomical variations in the celiac trunk is crucial for the success of various diagnostic and surgical procedures, including liver transplantation, splenectomy, and hepatobiliary and pancreatic operations. A lack of studies exists reporting the coexistence of celiac trunk variants and visceral variations, such as an accessory spleen.

Case report: During a routine dissection of 26 formalin-fixed cadavers for undergraduate students, the authors observed an anomalous celiac trunk in a 78-year-old woman. The typical trifurcation of the celiac trunk into the left gastric, splenic, and common hepatic arteries was absent. It was replaced by two trunks arising from the abdominal aorta: a gastrosplenic trunk branching into the left gastric and splenic arteries and a hepatomesenteric trunk giving rise to the superior mesenteric and common hepatic arteries. These two arterial trunks were consistent with the type V branching pattern of the celiac trunk based on the Adachi classification. Notably, two accessory spleens were also seen near the splenic hilum. Further dissection revealed an accessory left renal vein, a high origin of the right renal artery, and a common inferior phrenic artery trunk.

Conclusions: This is the first report of a combination of accessory spleens and variations in the celiac trunk and phrenic and renal vessels. The presented findings have implications for splenic, renal, and gastrointestinal surgery.