Anatomic variants of the celiac, superior mesenteric, and inferior mesenteric arteries and their clinical relevance

A thorough knowledge of the anatomy of the celiac, superior mesenteric, and inferior mesenteric arteries and their variants is necessary to accomplish a successful, uncomplicated abdominal operation. We examined the anatomy of these arteries in situ in 50 adult cadavers. The classic anatomic description of the celiac, superior mesenteric, and inferior mesenteric arteries was each confirmed in only 24%, 22%, and 16% of the cadavers, respectively. This infrequent occurrence of the textbook picture was due to the presence of one or more variants in 94% resulting from differences in arterial origin and spatial relationship. A left hepatic artery of left gastric artery origin was found in 20%. A right or common hepatic artery of superior mesenteric artery origin was observed in 14% and 6%, respectively. Of equal frequency to the classic pattern of the superior mesenteric artery was that in which the ileocolic artery arose separately and the right and middle colic arteries arose via a common trunk. The most common pattern of the inferior mesenteric artery was a left colic and a sigmoid artery arising from a common trunk with a second sigmoid artery from the inferior mesenteric artery in 28%. The embryologic basis, frequency in the literature, and clinical relevance of these variants are discussed.