Novel variant of hepatic and foregut vasculature

Purpose: The organs of the foregut are supplied by the celiac trunk, which branches into the common hepatic artery, splenic artery, and left gastric artery. The common hepatic artery further divides into the proper hepatic and the gastroduodenal arteries. The superior mesenteric artery usually supplies midgut components. Here we document a novel variation of the vascular supply of the liver that involves branches of both the celiac trunk and superior mesenteric artery. Methods: Routine cadaveric dissection of a 63-year-old white male. Results: In this case, the proper hepatic artery emerged from the superior mesenteric artery, and gastroduodenal artery branched directly off of the celiac trunk. At the hilum, the proper hepatic artery bifurcated to left and right hepatic arteries. Additionally, an accessory left hepatic artery was present branching from the left gastric artery. Conclusions: This combination of variants in the hepatic foregut vasculature has not been previously reported in the literature. Knowledge of published anatomical variations reinforces the benefit for pre-surgical imaging utilizing computed tomography angiography to improve surgical outcomes and enhance patient safety.