An Unusual Origin of the Celiac Trunk and the Superior Mesenteric Artery in the Thorax

作者：Matusz Petru; Iacob Nicoleta; Miclaus Gratian D; Pureca Ana; Ples Horia^*; Loukas Marios; Tubbs R Shane

来源：Clinical Anatomy, 2013, 26(8): 975-979.

DOI：10.1002/ca.22293

• celiac trunk
• superior mesenteric artery
• variation
• thoracic origin
• aortic hiatus
• median arcuate ligament
• acute downward aortomesenteric angle
• reduced aortomesenteric distance
• MDCT angiography

The authors report a case of a 44-year-old male found to have unusual origins of the celiac trunk (CT) and superior mesernteric artrery (SMA) as revealed by routine multidetector computed tomograph (MDCT) angiography. The CT and SMA originate from the thoracic aorta (TA) 21 mm and 9 mm above the aortic hiatus, respectively. The median arcuate ligament (MAL) is located at the level of the L1-L2 intervertebral disc. The course of the CT descends in the thoracic cavity making a 14 degrees acute downward angle in front of the TA; below the level of the MAL, the CT descends, making an angle of 47 degrees. The course of the SMA descends at both the thoracic and abdominal level making an angle of 17 degrees, and having an aortomesenteric distance of 9 mm at the level of the third part of the duodenum. In the present case, the supradiaphragmatic origin of the CT and the SMA was determined by their incomplete caudal descent, associated with a pronounced apparent descent of the diaphragm. A thoracic origin of the CT and SMA and the acute downward aortomesenteric angle (17 degrees) associated with a reduced aortomesenteric distance at the level of the third part of the duodenum (9 mm), although no clinical signs are present, may predispose the patient to develop simultaneously a triple syndrome: the compression of CT by MAL (celiac axis compression syndrome), the compression of SMA by MAL (superior mesenteric artery compression syndrome), and the compression of the duodenum by the SMA (superior mesenteric artery syndrome). Clin. Anat. 26:975-979, 2013.

• 出版日期2013-11