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Case Reports
. 2020 Oct-Dec;61(4):1317-1322.
doi: 10.47162/RJME.61.4.33.

Replaced right hepatic artery originated from splenic artery, in association with gastrosplenic trunk: a case report

Laura Andreea Bolintineanu  1 , Nicoleta Iacob, Agneta Maria Pusztai, Horia Pleş, Petru Matusz
Affiliations
Case Reports

Replaced right hepatic artery originated from splenic artery, in association with gastrosplenic trunk: a case report

Laura Andreea Bolintineanu et al. Rom J Morphol Embryol. 2020 Oct-Dec.

Abstract

The authors report a case of a 74-year-old woman found to have an extremely rare case highlighted by multidetector computed tomography (MDCT) angiography, with the presence of a replaced right hepatic artery (RRHA) arising from the splenic artery (SA). In this case, the SA arose from a gastrosplenic trunk (GST). The GST had an endoluminal diameter of 9.2 mm at its origin and a length of 9.3 mm. It arose directly from the anterior abdominal aortic wall, at the level of the T12-L1 intervertebral disc. The SA branched off from the GST and travelled in front of the abdominal aorta (AA) for 18.2 mm up to the level of the L1-L2 intervertebral disc. The SA then continued along an upward and tortuous path towards the splenic hilum. The inflection point of the SA trunk was located above the origin of superior mesenteric artery (SMA). The RRHA arose from the right of this inflection point. The RRHA had an endoluminal diameter of 3.0 mm at its origin and a length of 96.0 mm; it had a downward trajectory towards the hepatic hilum. The common hepatic artery (CHA) had an endoluminal diameter of 6.2 mm at origin and arose directly from the anterior wall immediately to the right of the mediosagittal plane of the AA. Knowledge of this rare anatomical variation is important for interventional radiologists, oncologists, hepatic and abdominal surgeons.

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Conflict of interest statement

The authors declare that they have no conflict of interests.

Figures

Figure 1
Figure 1
MDCT angiography of the AA and his branching pattern. The 3D VRT image revealed the presence of the GST, the origin of RRHA from SA and the presence of an in situ functional aortoiliac prosthetic graft. 3D: Three-dimensional; AA: Abdominal aorta; CHA: Common hepatic artery; GDA: Gastroduodenal artery; GST: Gastrosplenic trunk; LGA: Left gastric artery; MDCT: Multidetector computed tomography; PHV: Portal hepatic vein; RRHA: Replaced right hepatic artery; SA: Splenic artery; SMA: Superior mesenteric artery; SMV: Superior mesenteric vein; VRT: Volume rendering technique; *: Level of in situ of a functional aortoiliac prosthetic graft
Figure 2
Figure 2
MDCT angiography of the AA, GST, CHA and RRHA. The 3D VRT (A) and MIP (B) images of AA revealed a GST in association with a CHA independently arising from the AA and the RRHA arising from the phrenic artery. 3D: Three-dimensional; AA: Abdominal aorta; CHA: Common hepatic artery; GDA: Gastroduodenal artery; GST: Gastrosplenic trunk; HP: Head of pancreas; LGA: Left gastric artery; LHA: Left hepatic artery; LIPA: Left inferior phrenic artery; MDCT: Multidetector computed tomography; MIP: Maximum intensity projection; PHV: Portal hepatic vein; RB-PHA: Right branch of portal hepatic vein; RIPA: Right inferior phrenic artery; RRHA: Replaced right hepatic artery; SA: Splenic artery; SMA: Superior mesenteric artery; VRT: Volume rendering technique; *: Level of in situ functional aortoiliac prosthetic graft
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