Anatomical Variations of Celiac Trunk Anatomy and their Clinical Importance

Purpose of this study was to identify and evaluate the spectrum and prevalence of celiac axis (CA) variations and its branches. To study accurately the celiac trunk (CT) morphometry its diameter, length, distance from superior mesenteric artery (SMA) and its topography, as well as the diameter of SMA. Evaluation of the importance of these findings in patients (pts) management. Methods and Materials This prospective-single-center-study included 133 consecutive pts referred to our clinic for abdominal-CT-scans over a 9-month period. They 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. Results In our series, we identified normal trifurcation of CT (type-1-Michels) 84 pts (64 %), type-2-Michels-3 %, type -3-Mischel-1.3 %, type 5-Mischel-1 %, type6-Mischel-2 %, the other anatomical variations of the celiac trunk no included in Michels classification where found in 39 of patients (29 % of cases). Regarding topography, CT origin was found opposite T12-L1 junction (37 %), opposite T12 (31.9 %) or L1 vertebra (31.1 %). The length range of CT was 1.17 to 4, 5cm, its diameter 0.4 to 1.13cm, its distance from SMA 0.4 to 2.15cm, while the diameter ranges of SMA 0.51 to 1.05cm. Conclusion Our findings were similar to a certain range to previous studies. Recognition of CA variants requires a detailed description, and as previously noted a hypothetical anatomic model for summarizing the observed CA anatomical variations is needed. Recognition in detail of variations of CA anatomy and its morphometry is important in the accurate interpretation of disease, in diagnostic imaging, while it is indispensable in preventing complications during surgery/interventional radiology procedure.