Illustrated Encyclopedia of Human Anatomic Variation: Opus II:Cardiovascular System: Arteries: Abdomen: Variations in Branches ofCeliac Trunk
Splenic Artery
Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD
Peer Review Status: Internally Peer Reviewed
The variations of the splenic artery are numerous. It may divideinto two branches that reunite, the splenic vein passing through theloop thus formed. It may give rise to branches normally derived fromother vessels, such as the left gastric, middle colic, and lefthepatic.
The splenic artery supplies four to six (more or less) gastricvasa brevia arteries. These are terminal or end arteries. It canarise from the gastroepiploic artery, the splenic artery proper, thesplenic branches of the splenic artery, or any combination thereof.The left gastroepiploic artery may originate from one of the splenicbranches, rather than from the splenic artery proper.
The dorsal pancreatic artery arises from the splenic in 37% ofcases, the celiac in 33%, the superior mesenteric in 21%, and thecommon hepatic artery in 8%, typically close to the aorticsource.
As indicated in a previous section (celiac trunk), the celiactrunk may lack one or more of its main branches. In such cases, thebranch in question may arise from the aorta or the superiormesenteric, either independently or in conjunction with anotherbranch. Variations have been reported to occur with the followingfrequencies (approximate):
1) Hepatosplenogastric trunk; usual complement 90%.
2) Hepatosplenic trunk (hepatic and splenic) 3.5%.
3) Hepatosplenomesenteric trunk (hepatic, splenic, and superiormesenteric) 0.5%.
4) Hepatogastric trunk (hepatic and left gastric) 1.5%.
5) Splenogastric trunk (splenic and left gastric) 5.5%.
6) Celiacomesenteric trunk (superior mesenteric in conjunction withhepatosplenogastric trunk) 1.2-2.5%.
7) Celiacocolic trunk; middle or accessory middle colic arising fromthe celiac trunk is extremely rare (no frequency data isavailable).
The splenic and hepatic arteries have been described arising froma common trunk from the superior mesenteric artery. Krause (seeHenle) reported a case of Hyrtl's in which the splenic arose from thesuperior mesenteric. The splenic artery has been shown to give riseto the hepatic artery, which joined the superior mesenteric arteryand then branched from the superior mesenteric artery to supply theliver.
The inferior pancreatic artery may also supply the spleen.
The tortuous course of the splenic artery is considered sovariable that no two arteries are alike, but the tortuosity of theartery is absent in infants and children.
The splenic vein is not invested in a common sheath with theartery - it is retropancreatic and never tortuous.
Splenic arteries are end-arteries in the strictest sense, andinterference with the blood supply to the spleen will result innecrotic areas in the organ.
The splenic artery may course through the pancreas to reach thespleen. In congenital absence of the spleen (very rare), the splenicartery terminates in the pancreas.
Variant branches of the splenic artery:
The posterior gastric artery is a branch of the splenic and it ispresent 48 to 67.8% of individuals; DiDio et al. found it in 46% oftheir subjects. According to DiDio, the surgical importance of theposterior gastric artery derives from its relatively high incidence,from its being another source of the blood supply to the superiorportion of the posterior gastric wall and from having an almosthidden origin (from behind the splenic artery). In addition, itsupplies a superior polar to the spleen. It is important for thesurgeon to know of the existence of this cranially directed branchsof the splenic artery to the posterior gastric wall and the superiorpole of the spleen and of their variations. These vessels have a"hidden" posterior location and may be overlooked leading to thepossibility of dangerous bleeding if damaged. The posterior gastricartery was first described by Walther in 1729.
The splenic artery has been shown to give rise to esophagealarteries.
Image101, Image183, Image269
Superior
Image430
Middle Colic
See Image 101
Posterior Gastric
See Image 430
Dorsal Pancreatic
See Image 101
Superior (Splenic), Superior Polar (Splenic)
See Image 269
Posterior Superior Pancreatoduodenal
Image341
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