Replaced left and right hepatic arteries

Case contributed by Safwat Mohammad Almoghazy
Diagnosis certain

Presentation

A newly diagnosed case of Hodgkin lymphoma for CT assessment.

Patient Data

Age: 30 years
Gender: Male

Arterial phase CT shows upper abdominal arterial anatomy in this patient with both replaced left and right hepatic arteries.

The left hepatic artery can be seen coursing through the fissure for ligament venosum and originating from the superior aspect of the celiac trunk.

The right hepatic artery is centered in the hepatic hilum, and courses anterior to the main portal vein, originating with a gastroduodenal artery from a common trunk from the superior mesenteric artery.

As the hepatic arteries are both replaced, there is no common hepatic artery or proper hepatic artery.

No accessory hepatic arteries are visible.

Also,  there is a circumaortic left renal vein.

Case Discussion

This case nicely demonstrates two hepatic artery variants which typically occur independently of each other.

Also, a circumaortic left renal vein is noted.

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