Fortuitous discovery of a superior and posterior pancreaticoduodenal artery originating from the right branch of the hepatic artery during cadaver dissection.

Abstract

Introduction: The duodeno-pancreatic region is a highly vascularized area. The superior and posterior pancreaticoduodenal artery is a vessel primarily originating from the gastroduodenal artery. It exhibits rare anatomical variations, such as its emergence from the right branch of the hepatic artery, which we fortuitously identified during a cadaver dissection.

Materials and methods: The body studied in this dissection was from cadavers donated to science at the Anatomy Laboratory of the Faculty of Medicine in Amiens. This dissection was part of a Master's project aimed at studying the branches of the celiac trunk.

Results: We identified a superior and posterior pancreaticoduodenal artery arising from the right branch of the hepatic artery, coursing to the right of the gastroduodenal artery and sharing a very proximal anastomotic branch that gave rise to seven short retro-duodenal arteries. This artery provided branches to the bile duct and then ran along the duodenum and the pancreas while giving off about ten small branches to these two adjacent organs. It anastomosed with the posterior and inferior pancreaticoduodenal artery, which originated from the superior mesenteric artery.

Conclusion: Knowledge of this anatomical variation is fundamental for the visceral surgeon performing a cephalic duodenopancreatectomy, a resection of the pancreatic head with preservation of the duodenal framework, a resection of the pancreatic head with pancreatic-jejunostomy, or even in managing a hemorrhagic duodenal ulcer. This aberrant origin of the superior and posterior pancreaticoduodenal artery should also be known by the interventional radiologist during arterial embolizations related to the rupture of pseudoaneurysms of the pancreatic arcades.