Coeliac artery

The coeliac artery (also known as the coeliac trunk) is a major visceral artery in the body.

Origin

Arises anteriorly from abdominal aorta at T12, behind the median arcuate ligament, just as the aorta enters the abdomen. 

Course

It is typically a short vessel that passes underneath the median arcuate ligament, often indented on its superior surface by this ligament, and then courses anteriorly or slightly anterolaterally in the lesser sac.  It is surrounded by coeliac lymph nodes and the coeliac plexus. At the upper border of the pancreas it divides into 3 branches – left gastric artery, splenic artery and common hepatic artery.  The left gastric artery is usually the first branch, after which the coeliac artery bifurcates into the splenic artery and common hepatic artery.

Branches

• left gastric artery
• splenic artery
• common hepatic artery

Supply

The coeliac artery is the artery to the foregut, supplying:

• Gut from distal oesophagus to ampullary region of 2^nd part of duodenum
• Liver and gallbladder
• Spleen
• Pancreas

Variants

Classic branching of the coeliac artery into left gastric artery, splenic artery and common hepatic artery is seen in approximately 70%.  Variations are present in approximately 30%.  In general, any of the three coeliac branches may arise independently from the aorta or SMA, or the coeliac artery may give rise to other branches.

Extra-coeliac origin of its 3 branches

From aorta

• left gastric artery : 2 - 3%
• splenic artery : <1%
• common hepatic artery : 2%

From SMA

• left gastric artery : extremely rare
• splenic artery : <1%
• common hepatic artery : 2%

Other branches that may arise directly from coeliac artery

• dorsal pancreatic artery
• right hepatic artery                                   
• gastroduodenal artery
• inferior phrenic arteries

Other

• common origin of coeliac artery and SMA (coeliaco-mesenteric trunk) : < 1%

There is also a plethora of variations in the branching of the second and third order branches of the coeliac artery, particularly hepatic arterial anatomy which is discussed with the common hepatic artery.

Related pathology

• coeliac artery compression syndrome
• upper GI bleeding