Published online Dec 6, 2019. doi: 10.12998/wjcc.v7.i23.3980
Peer-review started: August 14, 2019
First decision: September 10, 2019
Revised: October 21, 2019
Accepted: November 14, 2019
Article in press: November 14, 2019
Published online: December 6, 2019
Processing time: 114 Days and 7.8 Hours
In previous studies, celiomesenteric trunk (CMT) was narrowly defined as a hepato-gastro-spleno-mesenteric (HGSM) trunk, but other possible types were ignored. With the widespread use of multidetector computed tomography (MDCT) angiography, it is easy to collect a large sampling of data on arterial anatomy of the abdomen in daily radiological practice. A new classification system for CMT may be created based on its MDCT angiographic findings and variation patterns.
To identify the spectrum and prevalence of CMT according to a new classification based on MDCT angiographic findings, and discuss the probable embryological mechanisms to explain the CMT variants.
A retrospective study was carried out on 5580 abdominal MDCT angiography images. CMT was defined as a single common trunk arising from the aorta and its branches including the superior mesenteric artery and at least two major branches of the celiac trunk. Various types of CMT were investigated.
Of the 5580 patients, 171 (3.06%) were identified as having CMT. According to the new definitions and classification, the CMT variants included five types: I, II, III, IV and V, which were found in 96 (56.14%), 57 (33.33%), 4 (2.34%), 3 (1.75%) and 8 (4.68%) patients, respectively. The CMT variants also were classified as long type (106 patients, 61.99%) and short type (65 patients, 38.01%) based on the length of single common trunk. Further CMT classification was based on the origin of the left gastric artery: Type a (92 patients, 53.80%), type b (57 patients, 33.33%), type c (11 patients, 6.43%) and type d (8 patients, 4.68%).
We systematically classified CMT variants according to our new classification system based on MDCT angiographic findings. Dislocation interruption, incomplete interruption and persistence of the longitudinal anastomosis could all be embryological mechanisms of various types of CMT variants.
Core tip: A new definition and classification system for celiomesenteric trunk (CMT) was created in our study. CMT can be classified into various types according to its variation patterns, origins of left gastric artery and length of single common trunk on multidetector computed tomography angiographic images. CMT is not very rare in these observed patients and has wide-ranging health implications. Dislocation interruption, incomplete interruption and persistence of the longitudinal anastomosis could all be embryological mechanisms of various types of CMT variants.