M. Tanka, F.Tuka, S. Qamirani E. Abazaj
Abstract: Purpose of this paper was to introduce two rare cases of uncommon celiac trunk (CT) variations, respectively hepatosplenomesenteric trunk (HSMT) with left gastric artery (LGA) deriving directly from the aorta and CT composed of LGA and splenic artery (SA) with the common hepatic artery (CHA) originating from the superior mesenteric artery (SMA). Coexistence of polisplenia and IVC anomalies were also seen in both patients (pts). In addition interatrial septal defect (IASD) with left atrial thromb was discovered in one of the pts. To discuss the clinical importance of these findings in patients (pts) management. Materials Both pts underwent MDCT and MDCT angiography with 120 ml i/v contrast medium at an injection speed of 3.5 and 4ml/s, with 3D-reconstructions. Result (s) Accidental finding of CT and IVC variations were found in both pts. The first pt was discovered to have a HSMT associated with azygos continuation of IVC and retroaortic left renal vein (RALRV). The next pt on the other hand revealed to have a CT composed of only the LGA and the SA whereas the common hepatic artery (CHA) derived from the MA. In addition the latter was also found to have IASD with left intraatrial thromb. Polisplenia was another incidental finding in both pts. Conclusion Detailed recognition of variations of CT and IVC anatomy is important in the accurate interpretation of disease, in diagnostic imaging, Awareness of such variations is crucial in preventing life threatening complications during surgery/interventional radiology procedures.
Keywords: celiac trunk, inferior venacava, azigos vein