Quadruple Arterial Blood Supply to the Liver: A Rare Variation
Bello S. S. *
Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria and Faculty of Medicine, Cyprus International University, Haspolat, Nicosia, North Cyprus, Via Mersin 10, Turkey.
Aliu Abdulhameed
Department of Anatomy, Faculty of Basic Medical Sciences, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Vascular variations in the liver are significant to surgeons in liver transplantations, radiological procedures, laparoscopy and penetrating abdominal injuries. These variations are important in liver transplantation procedure, in addition to being an ideal opportunity for surgical anatomy study, their detailed identification is crucial to the success of the procedure.
Case Report: During a routine cadaveric dissection of the abdomen for medical students at the department of Anatomy Usmanu Danfodiyo University, Sokoto Nigeria. A male adult cadaver with unknown identity and cause of death, was found to have four arterial branches to the liver, one each from the left gastric artery and common hepatic artery, a branch from the gastro-duodenal artery and the hepatic artery.
Conclusion: Detailed knowledge of the variations of hepatic arterial anatomy is of utmost importance to surgeons who perform surgeries in this area, particularly in liver transplantation, since their identification and proper management are critical to the success of the procedure.
Keywords: Quadriple, arterial, blood supply, liver, variation
How to Cite
Downloads
References
Varotti G, Gondolesi GE, Goldman J, Wayne M, Florman SS, Schwartz ME, et al. Anatomic variations in right liver living donors. J Am Coll Surg. 2004;198:577–582.
Hiatt JR, Gabbay J, Busuttil RW. Surgical anatomy of the hepatic arteries in 1000 cases. Ann Surg. 1994; 220:50–52.
Gruttadauria S, Foglieni CS, Doria C, Luca A, Lauro A, Marino IR. The hepatic artery in liver transplantation and surgery: vascular anomalies in 701 cases. Clin Transplant. 2001;15:359–363.
Suzuki T, Nakayasu A, Kawabe K, Takeda H, Honjo I. Surgical significance of anatomic variations of the hepatic artery. Am J Surg. 1971;122:505–512.
Covey AM, Brody LA, Maluccio MA, Getrajdman GI, Brown KT. Variant hepatic arterial anatomy revisited: digital subtraction angiography performed in 600 patients. Radiology. 2002;224:542–547.
Michels NA. Newer anatomy of the liver and its variant blood supply and collateral circulation. Am J Surg. 1966;112(3):337-47.
Gurgacz AM, Horbaczewska A, Klimek-Piotrowska W, Walocha J. Variations in hepatic vascularisation: lack of a proper hepatic artery. Two case reports. Folia Morphol (Warsz). 2011;70(2):130-4.
Moore KL, Authur FD. Clinically oriented Anatomy (5th ed). Ontario, Canada: Lippincitt Williams & Wilkins. 2006:609—16.
Kosaka M, Horiuchi K, Nishida K, Taguchi T, Murakami T, Ohtsuka A. Hepatopancreatic arterial ring: bilateral symmetric typology in human celiaco-mesenteric arterial system. Acta Med Okayama. 2002;56(5):245-53.
Moore KL, Persaud TV, Torchia MG. The developing human. E-book: clinically oriented embryology. Elsevier Health Sci. 2018:363—8.
Prakash, Rajini T, Mokhasi V, Geethanjali BS, Sivacharan PV, Shashirekha M. Coeliac trunk and its branches: anatomical variations and clinical implications. Singapore Med J. 2012;53(5):329– 331.
chwarz L, Huet E, Yzet T, Fuks D, Regimbeau JM, Scotte M. An extremely uncommon variant of left hepatic artery arising from the superior mesenteric artery. Surg Radiol Anat. 2014;36(1):91–94.
Lopez-Andujar R, Moya A, Montalva E, Berenguer M, De Juan M, San Juan F, Pareja E. et al. Lessons learned from anatomic variants of the hepatic artery in 1,081 transplanted livers. Liver Transpl. 2007;13(10):1401–1404.
Chierici A, Castaldi A, El Zibawi M, Edoardo R, Antonio I. How to deal with right hepatic artery coming from the superior mesenteric artery during minimally invasive pancreaticoduodenectomy: A systematic review. Hepatobiliary & Pancreatic Diseases International. Available:https://doi.org/10.1016/j.hbpd.2022.12.005
Chen CY, Lee RC, Tseng HS, Chiang JH, Hwang JI, Teng MM. Normal and variant anatomy of the hepatic arteries: angiographic experience. Chin Med J. 1998;61:17–23.
Kamel IR, Kruskal JB, Pomfret EA, Keogan MT, Warmbrand G, Raptopoulos V. Impact of multidetector CT on donor selection and surgical planning before living adult right lobe liver transplantation. AJR Am J Roentgenol. 2001;176:193–200.
Fasel JHD, Muster M, Gailloud P, Mentha G, Terrier F. Duplicated hepatic artery: radiologic and surgical implications. Acta Anat. 1996;157:164–8.
Weiglein AH. Variations and topography of the arteries in the lesser omentum in humans. Clin Anat. 1996;9:143–50.
Daly JM, Kemeny N, Oderman P, Botet J. Long-term hepatic arterial infusion chemotherapy. Arch Surg. 1984;119:936–41.
De Santis M, Ariosi P, Calo GF, Romagnoli R. Anatomia vascolare arteriosa epatica e sue varianti. Radiol Med 2000;100:145–51.
Koops A, Wojciechowski B, Broering DC, Adam G, Krupski-Berdien G. Anatomic variations of the hepatic arteries in 604 selective coeliac and superior mesenteric angiographies. Surg Radiol Anat. 2004;26: 239–44.
Erbay N, Raptopoulos V, Pomfret EA, Kamel IR, Kruskal JB. Living donor liver transplantation in adults: vascular variants important in surgical planning for donors and recipients. AJR Am J Roentgenol. 2003;181:109–14.
Abdullah SS, Mabrut JY, Garbit V, De LaRoche E, Olagne E, Rode A, et al. Anatomical variations of the hepatic artery: study of 932 cases in liver transplantation. Surg Radiol Anat. 2006; 28:468–73.
Chia TI, Oyeniran OI, Ajagbe AO, Onigbinde OA, Oraebosi MI. The symptoms and stress experienced by medical students in anatomy dissection halls. J Taibah Univ Med Sci. 2020;15:8.
International Federation of Associations of Anatomists (IFAA). Best practice guidelines for body donation programmes during the novel Coronavirus pandemic; 2020. Available:http://www.ifaa.net/wp-content/uploads/2020/05/IFAA.
Staement-on-COVID-19 -final-v2.pdf
[Assessed 15th January 2023].
Iwanaga J, Loukas M, Dumont AS, Tubbs RS. A review of anatomy education during and after the COVID-19 pandemic: Revisiting traditional and modern methods to achieve future innovation. Clinical Anatomy. 2021;34:108—14.
Onigbinde O, Ajagbe A, Oyeniran OI, Chia T. Post-COVID-19 pandemic: standard operating procedures for gross anatomy laboratory in the new normal. Morphologie. 2021;105(350):196-203.
Onigbinde OA, Chia T, Oyeniran OI, Ajagbe AO. The place of cadaveric dissection in post COVID-19 anatomy education. Morphologie. 2021;105(351): 259-266.