Celiac trunk and common hepatic artery variations in children: an analysis with CT angiography.

BACKGROUND: Understanding the celiac trunk and hepatic artery anatomy is important not only in preventing iatrogenic injuries but also in planning surgical procedures in children. Therefore, the aim of this study is to analyze the prevalence of celiac trunk (CeT) and common hepatic artery (CHA) variations in the pediatric population.

MATERIALS AND METHODS: One hundred and seventy-four children (174) who underwent abdominal multidetector computed tomography (MDCT) angiography, either because of trauma or liver transplantation, were analyzed retrospectively. The patterns of CeT, CHA and their variant branches were revealed and compared with previous studies involving adults.

RESULTS: A total of 157 (90.2%) of the 174 patients had normal celiac trunk anatomy, whereas 17 (9.8%) had variations. Five types of CeT variations were identified according to Song's classification in which 'Hepatosplenic trunk + Left gastric artery + Superior mesenteric artery' was the most prevalent. One hundred-twelve (64.4%) of the 174 patients had normal CHA anatomy; however 62 (35.6%) had variations. Six types of CHA variations were identified according to Michel's and Hiatt's classification. The most common was 'Replaced left hepatic artery originating from left gastric artery'.

CONCLUSIONS: The prevalence of celiac trunk and hepatic artery variations are high in children as much as in their elders. Awareness of these variations by is important in terms of avoiding iatrogenic injury and in promoting surgical procedure planning for liver transplantation or abdominal tumor surgery.