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An unusual case of a tortuous abdominal aorta with a common celiacomesenteric trunk: demonstrated by angiography.

Kara E, Celebi B, Yildiz A, Ozturk N, Uzmansel D - Clinics (Sao Paulo) (2011)

View Article: PubMed Central - PubMed

Affiliation: Mersin University, Mersin, Turkey.

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The abdominal aorta (AA) begins at the aortic hiatus of the diaphragm, in front of the lower border of the body of the last thoracic vertebra and descending in front of the vertebral column and ends on the body of the fourth lumbar vertebra, commonly a little to the left of the middle line by dividing into the two common iliac arteries... The celiac trunk (CeT) and superior mesenteric artery (SMA) are the two widest vessels arising from the ventral aorta... The celiac trunk divides into the left gastric, common hepatic and splenic arteries... Additionally, a common celiacomesenteric trunk was observed during the tortuous course of the AA (Figures 1‐3)... The trunk first gave the common hepatic and splenic arteries, and then split into the left gastric artery and the superior mesenteric trunk... Variation of the left gastric, splenic, common hepatic and SMAs from a common CMT, as in the present case, is rare... There is only one case reported in the literature in which a CMT with a tortuous upper abdominal aorta was demonstrated by angiography having aneurysmal and occlusive disease... However, in that case, CMT did not originate from the tortuous part of the AA but directly originated from the tortuous section of the AA... The pattern of a CMT or a similar arterial variation may vary on a case by case basis... Çiçekcibaşi et al. demonstrated a CMT in which the inferior phrenic arteries also arose from this trunk and the trunk then gave rise to the left gastric, common hepatic, splenic, left gastroepiploic arteries and, as a short stem, the superior mesenteric artery... Nonent et al. reported a common origin of the celiac, superior mesenteric and inferior mesenteric arteries that they have called a celiac‐bimesenteric trunk... It is worth bearing in mind that dramatic complications of intra‐aortic approaches can occur in a tortuous coursing aorta such as rupturing of the vessel by a straight‐tipped catheter or an intra‐aortic ballon pump catheter. - Also worth noting is that a varied branching pattern, such as a CMT from the AA can be significant in radiologic and surgical interventions.

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3D computed tomography (CT) angiography. A  =  aorta; T  =  tortuousity; H  =  common hepatic artery; S  =  splenic artery; CMT  =  common celiacomesenteric trunk; SM  =  superior mesenteric artery; RR  =  right renal artery; LR  =  left renal artery.
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f1-cln_66p169: 3D computed tomography (CT) angiography. A  =  aorta; T  =  tortuousity; H  =  common hepatic artery; S  =  splenic artery; CMT  =  common celiacomesenteric trunk; SM  =  superior mesenteric artery; RR  =  right renal artery; LR  =  left renal artery.

Mentions: During the coronary angiography of a 58‐year‐old Caucasian female patient, from whom informed consent was obtained, the catheter directed through the femoral artery was blocked in the abdominal aorta. Axillary artery approach was attempted to see if there were any anomalies in the AA. Angiography and computed tomography (CT) angiography of the abdominal aorta demonstrated a horizontally U‐shaped tortuousity that hindered the proximaly movement of the catheter (Figure 1). There was no anomaly in the region causing such a tortuosity. Additionally, a common celiacomesenteric trunk was observed during the tortuous course of the AA (Figures 1‐3). The trunk first gave the common hepatic and splenic arteries, and then split into the left gastric artery and the superior mesenteric trunk. The inferior mesenteric artery appeared to have a normal origin and course. There was no aneurysm formation or occlusion during the course of the CMT or aortic dissection in this patient.


An unusual case of a tortuous abdominal aorta with a common celiacomesenteric trunk: demonstrated by angiography.

Kara E, Celebi B, Yildiz A, Ozturk N, Uzmansel D - Clinics (Sao Paulo) (2011)

3D computed tomography (CT) angiography. A  =  aorta; T  =  tortuousity; H  =  common hepatic artery; S  =  splenic artery; CMT  =  common celiacomesenteric trunk; SM  =  superior mesenteric artery; RR  =  right renal artery; LR  =  left renal artery.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3044582&req=5

f1-cln_66p169: 3D computed tomography (CT) angiography. A  =  aorta; T  =  tortuousity; H  =  common hepatic artery; S  =  splenic artery; CMT  =  common celiacomesenteric trunk; SM  =  superior mesenteric artery; RR  =  right renal artery; LR  =  left renal artery.
Mentions: During the coronary angiography of a 58‐year‐old Caucasian female patient, from whom informed consent was obtained, the catheter directed through the femoral artery was blocked in the abdominal aorta. Axillary artery approach was attempted to see if there were any anomalies in the AA. Angiography and computed tomography (CT) angiography of the abdominal aorta demonstrated a horizontally U‐shaped tortuousity that hindered the proximaly movement of the catheter (Figure 1). There was no anomaly in the region causing such a tortuosity. Additionally, a common celiacomesenteric trunk was observed during the tortuous course of the AA (Figures 1‐3). The trunk first gave the common hepatic and splenic arteries, and then split into the left gastric artery and the superior mesenteric trunk. The inferior mesenteric artery appeared to have a normal origin and course. There was no aneurysm formation or occlusion during the course of the CMT or aortic dissection in this patient.

View Article: PubMed Central - PubMed

Affiliation: Mersin University, Mersin, Turkey.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

The abdominal aorta (AA) begins at the aortic hiatus of the diaphragm, in front of the lower border of the body of the last thoracic vertebra and descending in front of the vertebral column and ends on the body of the fourth lumbar vertebra, commonly a little to the left of the middle line by dividing into the two common iliac arteries... The celiac trunk (CeT) and superior mesenteric artery (SMA) are the two widest vessels arising from the ventral aorta... The celiac trunk divides into the left gastric, common hepatic and splenic arteries... Additionally, a common celiacomesenteric trunk was observed during the tortuous course of the AA (Figures 1‐3)... The trunk first gave the common hepatic and splenic arteries, and then split into the left gastric artery and the superior mesenteric trunk... Variation of the left gastric, splenic, common hepatic and SMAs from a common CMT, as in the present case, is rare... There is only one case reported in the literature in which a CMT with a tortuous upper abdominal aorta was demonstrated by angiography having aneurysmal and occlusive disease... However, in that case, CMT did not originate from the tortuous part of the AA but directly originated from the tortuous section of the AA... The pattern of a CMT or a similar arterial variation may vary on a case by case basis... Çiçekcibaşi et al. demonstrated a CMT in which the inferior phrenic arteries also arose from this trunk and the trunk then gave rise to the left gastric, common hepatic, splenic, left gastroepiploic arteries and, as a short stem, the superior mesenteric artery... Nonent et al. reported a common origin of the celiac, superior mesenteric and inferior mesenteric arteries that they have called a celiac‐bimesenteric trunk... It is worth bearing in mind that dramatic complications of intra‐aortic approaches can occur in a tortuous coursing aorta such as rupturing of the vessel by a straight‐tipped catheter or an intra‐aortic ballon pump catheter. - Also worth noting is that a varied branching pattern, such as a CMT from the AA can be significant in radiologic and surgical interventions.

Show MeSH
Related in: MedlinePlus