Investigating the misguided path of the superior epigastric artery: an anatomical study of 40 human donors.

Abstract

This study addresses a longstanding discrepancy between the observed course of the superior epigastric artery (SEA) in human donors and its depiction in many German-language anatomy textbooks. While the SEA typically runs ventral to the diaphragm, several textbooks inaccurately describe it as passing through the sternocostal triangle (Larrey's fissure). Anatomical dissections were performed on 40 formalin-fixed human donors at the Medical University of Vienna. The thoracic and abdominal walls were systematically dissected, and the course of the SEA was documented. Additionally, historical literature from Dominique Larrey to present-day sources was analyzed to trace the origin and persistence of the inaccurate anatomical description. In all specimens, the SEA remained ventral to the pleural and peritoneal cavities and did not traverse Larrey's space. The misinterpretation appears to have originated in the 19th century through a chain of misreadings that began with Joseph Hyrtl and was later codified by Friedrich Merkel and was subsequently perpetuated in various German-language anatomical references. This study challenges the traditional textbook depiction of the SEA's pathway through Larrey's space and suggests that historical anatomical literature should be revised to reflect accurate topographical relationships.