Anatomical variations of the hepatic artery in patients who undergo Contrast Enhanced Computed Tomography (CECT) abdomen at a tertiary care hospital in Sri Lanka.

Background and objective- Research on hepatic arterial anatomy is pivotal due to its clinical relevance for hepato-biliary interventions. Evidence on variant anatomy of hepatic vasculature is scarce in Sri Lanka. We aimed to assess the anatomical variations of the hepatic artery using Michel’s classification and determine their association with gender and ethnicity. Methods- Patients above the age of five years who underwent CECT abdomen in arterial phase from August to December 2023 were consecutively recruited. CECT images were analysed, and recorded with socio-demographic information of the patients. Chi-square tests were used to compare proportions. Results- Among 139 participants, the majority were males (51.8%), middle-aged (54.7%) and Sinhalese (81.3%). 24.5% showed an anatomical variation of the hepatic artery. The most common variant patterns were replaced left hepatic artery (7.2%), replaced right hepatic artery (5%) and common hepatic artery arising from superior mesenteric artery (3.6%). Females had a 13% increased chance for hepatic artery variations compared to males, but this association was not statistically significant (p=0.73). Tamil participants recorded the highest proportion of variant anatomy (33%) but the differences between ethnicities were not significant (p=0.66). Only one participant showed an atypical distribution that did not match Michel’s categories. Conclusions- Variant hepatic arterial anatomy in this Sri Lankan clinical population largely tallied the global prevalence but with different patterns. Further research is needed into the gender- and ethnic- differences and atypical variations identified by this study.