The foregut is the region of the digestive system that is made up of organs from the mouth to the duodenum, which is the first part of the small intestine, and the celiac trunk (celiac artery) is the major artery that supplies blood to the foregut. In this post, we are going be discussing the Celiac trunk/artery, explaining its origin, its location, and the region it supplies. In simple terms, I will be explaining the anatomy of the Celiac artery.
The celiac trunk originates from the abdominal aorta in the twelfth thoracic vertebra (T12) and L1 in the human spine, which supplies blood to the abdomen, and the abdominal viscera. The trunk then splits into three further arteries which are the Common Hepatic Artery, the Left gastric Artery, and the Splenic Artery. Also, the Inferior Phrenic Artery which supplies the diaphragm can arise from the Celiac trunk or from the abdominal trunk above the Celiac artery.
Image Credit
The Common Hepatic artery is the first major branch of the celiac trunk. It is larger than the left gastric artery, running downwards and to the right to reach the upper surface of the duodenum. The Common Hepatic artery splits into two arteries known as the Proper hepatic artery (a quick reminder, it supplies blood to the liver), and the Gastroduodenal artery (supplies blood to the stomach and the duodenum). The proper hepatic artery then splits into two which are the Left Hepatic artery (which supplies blood to the left lobe of the liver), and the Right Hepatic Artery (which supplies blood to the right lobe of the liver). In the Right Hepatic artery is a split artery known as the Cystic Artery (it supplies blood to the gallbladder). The Gastroduodenal artery splits to give the Right Gastroepiploic artery. The Common Hepatic artery also splits to form the Right Gastric Artery. The Gastroduodenal artery also splits to form the Superior Pancreatico-Duodenal Arteries which connects to the **inferior pancreatico-duodenal arteries which arises from the Superior Mesenteric Artery.
I mentioned that the Celiac trunk also splits to become the Left gastric Artery. The Left Gastric Artery runs downwards towards the cardiac end and the lesser curvature of the stomach. It supplies blood to the stomach, the esophagus, and the lower part of the spleen. The Left Gastric Artery splits to create the Esophageal branches which supply the Esophagus, the Short Gastric Arteries which supply blood to the stomach, the splenic artery which supplies blood to the spleen, the left gastro-omental artery which supplies blood to the greater curvature of the stomach, the left gastroepiploic artery which supplies blood to the greater omentum.
The Splenic Artery is the third major branch of the Celiac artery which splits to give the left gastroepiploic artery and the Short Gastric Arteries. The right and left gastroepiploic arteries connect together.
Clinical Significance of Celiac Trunk
- Celiac artery compression syndrome
Celiac artery compression syndrome is also known as median arcuate ligament syndrome. It is a rare condition in which the celiac artery is compressed by the median arcuate ligament, leading to decreased blood flow to the abdomen. Symptoms would include abdominal pain, bloating, weight loss, and malnutrition. Celiac artery compression syndrome is common in young adult people. Diagnosing Celiac artery compression syndrome can be done via computed tomography (CT) or magnetic resonance imaging (MRI), and arteriography. Treatment can be done by Laparoscopic surgery to release the compression on the Celiac artery.
- Peptic Ulcer Disease
Peptic ulcer disease (PUD) refers to the development of sores or ulcers in the lining of the stomach or small intestine, as a result of infection from bacteria such as Helicobacter pylori, excessive use of non-steroidal anti-inflammatory drug (NSAID), or tobacco smoking. These causes the erosion of lining of the stomach and the small intestine by the stomach acid and pepsin. Patients will have symptoms such as pain at the upper part of the stomach usually after meals in gastric ulcer, while with duodenal ulcer the pain reduces after meals, patients will experience heartburn, bloating, vomiting, and weight loss. Patients can be diagnosed for Peptic Ulcer disease using Esophagogastroduodenoscopy (EGD) test.
- Celiac Aneurysm
This is rare condition that involves the dilation or bulging of the celiac artery. The condition is asymptomatic until the celiac artery ruptures.Rupture of the Celiac artery can lead to severe internal bleeding and shock, and it becomes a crucial case to be treated to prevent morbidity and mortality. Symptoms of Celiac Aneurysm includes abdominal pain, nausea, vomiting, and weight loss. Patients could see lump in the abdomen as a result of the swelling of the celiac artery. Diagnosis of Celiac Aneurysm would be computed tomography (CT) scan, arteriography, and its treatment would be surgery.
- Spontaneous Celiac Trunk Dissection
This is a rare condition where the celiac trunk suddenly and unexpectedly tears or dissects. Factors that could lead to Spontaneous Celiac Trunk Dissection includes atherosclerosis, hypertension, increase in intra-abdominal pressure, pre-existing vascular diseases such as fibromuscular dysplasia, and even pregnancy. Diagnosis include CT angiography, magnetic resonance (MR) angiography and sonography. Treatment would be surgical procedure allowing for the management of the Celiac trunk dissection, and in most cases, preventing the thromboembolic events is key to managing the clinical condition.
Conclusion
While there are several arteries in the body, the Celiac trunk is a very important blood vessel which allows for blood to get to the abdomen and the abdominal viscera. A damage to the vessels and arteries can be very fetal leading to death.
National Library of Medicine - Anatomy, Abdomen and Pelvis, Celiac Trunk
National Library of Medicine - Spontaneous celiac artery dissection and its management