Presentation
Incidental finding in patient with lower limb ischaemia.
Patient Data
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.
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 1:
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
type X: the CHA from the left gastric artery
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