Also known as truncus coeliacus or the celiac trunk or axis, the celiac artery is an important visceral artery occurring in the abdominal cavity. It measures 1.25 cm in length and is the abdominal aorta’s first important branch. The abdominal aorta is the biggest artery present in the abdominal cavity.
The celiac artery supplies oxygenated blood to the spleen, stomach, esophagus, liver, and to sections of the duodenum and pancreas. It is considered as one of the three main frontal/midline braches of the abdominal aorta, with the two others being the inferior and superior mesenteric arteries. It may be noted that each of these artery branches service different areas, with the celiac artery servicing many vital organs. Absence of the celiac artery would result in nil blood supply to the organs and tissues that it services, leading to their eventual dysfunction.
The celiac artery consists of 3 main divisions, i.e., the common hepatic artery, the left gastric artery, and the splenic artery. The common hepatic artery transfers blood to the duodenum, liver, pancreas, and a section of the stomach; the left gastric artery continues along the stomach’s minor curve and attaches to the lower esophagus; and the splenic artery transfers blood to the spleen, an organ that produces antibodies and helps the immune system.
Celiac Artery – Anatomy
- The celiac artery arises from the front of the abdominal aorta at the T12 vertebral level, posterior to the median arcuate ligament, at the point when the aorta passes into the abdominal cavity. The short vessel runs onwards under the median arcuate ligament and usually bears indentation of this ligament on its upper surface. It then continues somewhat anterolaterally or anteriorly in the lesser sac. The vessel is enclosed by the coeliac plexus and the coeliac lymph nodes. At the superior edge of the pancreas, the celiac artery braches into 3 different arteries, wherein the left gastric artery is the 1st branch, after which there is division of the coeliac artery into the common hepatic artery and the splenic artery.
- Variation in structure: Nearly 70 percent of the general population exhibits celiac artery anatomy wherein it features the gastric, splenic, and common hepatic artery branches. The rest of the population may sometimes show a variation in celiac artery structure, wherein the 3 different branches may commence independently from the SMA or the aorta itself, or the celiac artery may feature additional branching and divisions, such as right hepatic artery, dorsal pancreatic artery, inferior phrenic arteries, and gastroduodenal artery. Also, the 2nd and 3rd order branches of the celiac artery may elicit several kinds of variations with regards to subsequent branching. This is especially common with the structure of the hepatic artery.
Celiac Artery – Functions
- The celiac artery is responsible for supplying oxygen-rich blood to the stomach, liver, spleen, abdominal esophagus, and the upper half of the pancreas and the duodenum. These are similar to the embryonic foregut. It may be noted that the inferior mesenteric artery and the superior mesenteric artery supply the structures and tissues arising from the embryonic hindgut and midgut, respectively. Another point to remember is the fact that these 3 abdominal aorta anterior branches are unique and cannot perform the function of the other, but there may be some restricted connections between the end branches of these 3 arteries.
- The interconnections occurring between the celiac artery and other main arteries present in the abdominal cavity are not enough to sustain sufficient perfusion. Therefore, the celiac artery is one of the most important sources of blood for the gut and hence cannot be ligated in a living individual without causing any damage. Blockages in the celiac artery can trigger necrosis or death of the structures that it services.
- There are no other major arteries that provide nourishment for the abdominal and digestive organs other than the celiac artery. Most of the blood coming back from the digestive system organs gets routed via the portal venous system to the liver for further detoxification and processing, before it gets back into the circulation system of the body through the hepatic veins. As opposed to the inferior mesenteric vein and the superior mesenteric vein that respectively help drain the hindgut and midgut organs, the celiac artery venous return is via either the emptying of the splenic vein into the hepatic portal vein or through smaller braches of the portal venous system.
Stenosis of the Celiac Artery
- Also called celiac artery compression syndrome, celiac artery stenosis is an unusual condition that causes significant reduction in the quantity of blood that arrives at the stomach and other tissues of the abdomen. It often affects underweight women and the young. The condition is marked by compression of the celiac artery due to anomalous formation of the median arcuate ligament. The increased pressure of the ligament on the celiac artery limits the total quantity of blood that the artery can supply to the abdominal region, thereby causing a host of abnormal symptoms.
- Symptoms: Patients affected by celiac artery stenosis commonly suffer from varied gastrointestinal symptoms such as pain in the abdomen after eating, chronic and sharp pain in the upper region of the abdomen, and extreme loss of weight.
- Patients may also suffer from cardiovascular symptoms such as the development of an abdominal bruit. An abdominal bruit can be described as a murmur, i.e., an irregular sound which accompanies the blood flow across the body. Doctors may place a stethoscope over that section of the abdomen which is home to the abdominal aorta so as to listen to the murmur.
- Causes: Doctors are unaware about the exact cause that triggers the development of celiac artery stenosis. However, as the condition is congenital, medical experts have found that unsual location of the median arcuate ligament as one of the causes. Studies have also shown that twins are at increased risk to developing the condition than single newborns, which in turn indicates that the condition may occur due to anomalous development of the fetus when in the uterus.
- Treatment: Treatment involves surgical easing of the pressure exerted on the celiac artery by the ligament. The removal of artery compression however has not resulted in easing of symptoms in all patients. Hence, new treatment options are currently being looked into.