Atypical origin of cystic artery from superior mesenteric artery and untimely termination of common hepatic artery: Concurrent arterial variation in the supra-colic compartment

Abstract

Secure laparoscopic cholecystectomy operation requires a sound anatomical knowledge of cystic artery (CA) and all possible variations involving it. Very rarely the CA arises from an extra territorial source of celiac axis. Since CA is to be ligated always during cholecystectomy, its variant origin, course and position in the Calot′s triangle should be carefully noted. We report here a concurrent arterial variation showing rare origin of CA from superior mesenteric artery and trifurcation of common hepatic artery into right and left hepatic artery together with gastro duodenal artery just above the proximal part of the duodenum. Among the branches of celiac trunk, variant morphology of its common hepatic branch is reported to be rare. Ample knowledge of multiple arterial variations in the supracolic compartment of the abdominal cavity warrants the clinical attention. Overlooking such variations might result in iatrogenic injury to the vessels leading to fatal haemorrhage during surgical approaches.

Keywords

• Common hepatic artery
• cystic artery
• superior mesenteric artery
• trifurcation