Clinical implications of the hepatomesenteric trunk–case report and literature review

Mark Shacker , Artur Rybachok , Benjamin R. Paul , Manuel Cevallos
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引用次数: 0

Abstract

Purpose

Variants of the abdominal vasculature profoundly impact the fields of interventional radiology and surgery. The “hepatomesenteric trunk” is a unique abdominal variant wherein the common hepatic artery arises directly from the superior mesenteric artery.

Methods

A narrative literature review was conducted to thoroughly characterize the hepatomesenteric trunk, including its reported prevalence, embryological origin, and implications in clinical practice. A detailed description of this variant found in a donor was also presented.

Results

The prevalence of the hepatomesenteric trunk ranges from 1.0 to 4.5 % in ten comprehensive studies. In as many as 90 % of cases, the hepatomesenteric trunk may be accompanied by a “gastrosplenic trunk,” wherein the left gastric and splenic arteries share a common origin.

Significance

This variant uniquely impacts foregut and midgut perfusion, and knowledge of this and other splanchnic arterial variants is essential for procedures such as pancreaticoduodenectomy, arterial reconstruction, mesenteric revascularization, and transarterial chemoembolization. A detailed preoperative workup, meticulously planned surgical approach, and comprehensive knowledge of such variants are essential to mitigate the risk of vascular injury in abdominal procedures.
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肝肠系膜主干病例报告及文献复习的临床意义
目的腹腔血管的变异对介入放射学和外科领域有着深远的影响。“肝肠系膜干”是一种独特的腹部变异,其中肝总动脉直接起源于肠系膜上动脉。方法对肝肠系膜干进行叙述性文献回顾,包括其报道的患病率、胚胎学起源和临床意义。在供体中发现的这种变异的详细描述也被提出。结果在10项综合研究中,肝肠系膜干的患病率在1.0 ~ 4.5%之间。在多达90%的病例中,肝肠系膜干可能伴有“胃脾干”,其中左胃动脉和脾动脉有共同的起源。意义:这种变异对前肠和中肠灌注有独特的影响,了解这种变异和其他内脏动脉变异对胰十二指肠切除术、动脉重建、肠系膜血运重建术和经动脉化疗栓塞等手术至关重要。详细的术前检查,精心计划的手术入路,以及对这些变异的全面了解对于减轻腹部手术中血管损伤的风险至关重要。
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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
71
审稿时长
25 days
期刊介绍: Translational Research in Anatomy is an international peer-reviewed and open access journal that publishes high-quality original papers. Focusing on translational research, the journal aims to disseminate the knowledge that is gained in the basic science of anatomy and to apply it to the diagnosis and treatment of human pathology in order to improve individual patient well-being. Topics published in Translational Research in Anatomy include anatomy in all of its aspects, especially those that have application to other scientific disciplines including the health sciences: • gross anatomy • neuroanatomy • histology • immunohistochemistry • comparative anatomy • embryology • molecular biology • microscopic anatomy • forensics • imaging/radiology • medical education Priority will be given to studies that clearly articulate their relevance to the broader aspects of anatomy and how they can impact patient care.Strengthening the ties between morphological research and medicine will foster collaboration between anatomists and physicians. Therefore, Translational Research in Anatomy will serve as a platform for communication and understanding between the disciplines of anatomy and medicine and will aid in the dissemination of anatomical research. The journal accepts the following article types: 1. Review articles 2. Original research papers 3. New state-of-the-art methods of research in the field of anatomy including imaging, dissection methods, medical devices and quantitation 4. Education papers (teaching technologies/methods in medical education in anatomy) 5. Commentaries 6. Letters to the Editor 7. Selected conference papers 8. Case Reports
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