Accessory left hepatic artery

Case contributed by Dr Abdulmajid Bawazeer


Incidental finding in patient with lower limb ischemia.

Patient Data

Age: 40 years
Gender: Male

A small arterial branch originating from the left gastric artery helps supply the left liver lobe.
The common hepatic artery gives left and right hepatic arteries.
Abdominal aorta appears normal in size with no filling defects or aneurysmal dilatation.

Annotated image

LHA = Left hepatic artery.
RHA = Right hepatic artery.
CHA = Common hepatic artery.
LGA = Left gastric artery.
RPA = Right phrenic artery.

Case Discussion

In our case, Type V hepatic artery anatomy according to Michels classification.

Michels described the hepatic arterial anatomy and its variations using the results of 200 cadaveric dissections and identified 10 types of hepatic arterial anatomy: type I: normal pattern; type II: a replaced LHA from the left gastric artery; type III: a replaced RHA from the SMA; type IV: replaced RHA and LHA; type V: an accessory LHA; type VI: an accessory RHA; type VII: accessory RHA and LHA; type VIII: a replaced RHA or LHA with other hepatic artery being an accessory one; type IX: the hepatic trunk as a branch of the SMA; and type X: the CHA from the left gastric artery1.

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