Incomplete celiac trunk with replaced hepatic arteries: a rare cadaveric case and embryologic interpretation.

摘要

BACKGROUND: The celiac trunk and superior mesenteric artery (SMA) are developmentally interconnected, and variations in one system often directly influence the other. Although classifications have been proposed for each structure, combined variations involving the celiac trunk, SMA, and their branches remain rare. CASE REPORT: We report combined variations involving the celiac trunk, SMA, and their branches, identified during routine educational dissection of an 80-year-old male cadaver in 2025. RESULTS: A rare combined vascular variation comprising an incomplete celiac trunk and a hepato-mesenteric trunk was identified: (1) a gastro-hepatic trunk that bifurcated into the left gastric artery and a replaced left hepatic artery; (2) a gastroduodenal- splenic trunk that bifurcated into the gastroduodenal artery and splenic artery; (3) absence of the common hepatic artery; and (4) a hepato-mesenteric trunk that gave rise to a replaced right hepatic artery and then continued as the SMA. The replaced hepatic arteries correspond to the type IV variant in the Michels and Hiatt classifications, which do not account for an incomplete celiac trunk. CONCLUSIONS: This case demonstrates a unique combined variation involving an incomplete celiac trunk, the SMA, and their branches. Awareness of such patterns and their embryologic basis may reduce iatrogenic vascular injury during upper abdominal and hepatobiliary procedures.