Detecting Anatomical Variations of Coeliac Trunk Branching Pattern in the Population of Karachi Using 3D Multidetector Computed Tomographic Angiography (MDCTA)

Abstract

Objective: To find out the frequency of variations in coeliac trunk branching pattern by Using 3D Multidetector Computer Tomographic Angiography (MDCTA),in patients referred to Radiology Department of Ziauddin University Hospital with abdominal pain, altered bowel habits, kidney or adrenal pathologies Method: For this study, 160 individuals aged 20-60 years, without any abdominal vascular or upper ab- dominal visceral disease who presented to Radiology Department, Ziauddin University Hospital, Clifton Karachi, for abdominal 3D-MDCTA (3-dimensional multidetector computed tomographic angiography) from March 2017 to August 2017 were recruited in this study. It was a cross-sectional study and samples were collected through non-probability convenience sampling technique. Recruitment of study participants was done from patients who were referred to radiology department of Ziauddin University Hospital for abdominal contrast MDCTA examination due to various indications such as abdominal pain, altered bowel habits, kidney and adrenal pathologies. Persons having serum creatinine levels <1.4 mg/dl with no hepatobiliary pathologies, pancreatic or abdominal vascular lesions were included while patient having, abdominal malignancy distorting vascular anatomy, vasculitis and atherosclerosis were ex- cluded from the study. Patients having history of liver transplant or upper abdominal surgeries or those having history of allergic reaction to contrast agents and pregnant ladies were also excluded from the study. Coeliac trunk variations were categorised according to Uflacker's classification into 8 types. Statis- tical analysis was done on SPSS version 20. Data is presented in percentages and frequencies. Results: Classical coeliac trunk (type I) was present in 134 out of 160 (83.9%) individuals while 26 (16.1%) individuals showed coeliac trunk variations. Type II and type V variations were second most fre- quent variations i.e. in 9 (5.6%) individuals each, followed by type VII in 5 (3.6%) individuals. Type III, IV and VI showed variations in 1 (0.6%) individual each. Type VIII was not found in our sample. Conclusion: The present study reports normal configuration of coeliac trunk i.e, classic or type I coeliac trunk in 83.9% individuals and coeliac trunk variations in 16.1% individuals.

Keywords

• Celiac artery, multidetector computed tomography, laparoscopy, anatomic variations, arterio- venous anastomosis.