Variation in branching pattern of splenic artery and its surgical importance

Introduction

Splenic artery commonly called as lineal artery being the largest branch of celiac trunk in adults and next largest to common hepatic artery in fetal life making tortuous course in stomach bed. It courses superior and anterior to the splenic vein, along the superior border of the pancreas. Near the splenic hilum, the artery usually divides into superior and inferior terminal (IT) branches, and each branch further divides into four to six segmental intrasplenic branches.1 The branches of splenic artery entering into the spleen through poles of the spleen are called polar arteries, i.e., superior and inferior polar arteries.2 The gastric branches of the splenic artery include the left gastroepilpoic, short gastric artery and sometimes, posterior gastric artery (PGA). PGA when present arises from the splenic artery in its middle section posterior to the body of the stomach. It ascends behind the peritoneum of the lesser sac towards the fundus of stomach and then reaches the posterior surface of the stomach in the gastrophrenic fold.3 The PGA supplies the superior portion of the posterior wall of the gastric body, near the cardiac area, and the fundus. Many variations in the course and branching patterns of splenic artery are mentioned in the literature.4, 5, 6, 7, 8

This variation in the branching pattern of the splenic artery can be correlated with its embryological development. The coeliac, superior mesenteric and inferior mesenteric arteries are derived from fusion of the vitelline arteries supplying the yolk sac, and are located in the dorsal mesentery of the gut. These vessels supply the derivatives of the foregut, midgut and hindgut.9 Embryologically, the splenic artery is derived from the celiac trunk.10 It supplies the spleen, pancreas, stomach and greater omentum.11

Materials and Methods

During the routine dissection about 60 cadavers were studied for the branching pattern of splenic artery in the Department of Anatomy, Subbaiah Institute Of Medical Sciences, Shivamogga and Government Vellore Medical College, Vellore.

Peritoneal cavity was explored and stomach was turned superiorly. The celiac trunk was identified and cleared and branches were traced. The splenic artery was traced distally and the terminal branching pattern was noted. The splenic artery and its terminal branches were painted with red color and photographed.

Observation and Results

In our study, we observed that the Splenic artery entered the hilum without branching [Figure 1] in 10 cadavers (16.7%). Distributed type [Figure 2] was observed in 36 cases (60%) and Bundled/ Marginal type, [Figure 3] was seen in 14 cases (23.3%).

Figure 1

Splenic artery without any terminal branches enters the spleen. {SA – Splenic artery, S – Spleen, LGEA – Left gastro epiploic artery}

Figure 2

Distributed type with long terminal branches

Figure 3

Bundled type with short terminal branches

Discussion

The present study clearly indicates that there is variation in origin, course, and terminal distribution pattern of the splenic artery. The knowledge of these variations are of significant importance during surgical and radiological procedure of upper abdominal region to avoid any catastrophic complications.

Conclusion

Spleen can be preserved in distributed and bundled type of splenic artery during splenic surgeries whereas in distal terminal branching pattern even embolization is possible selectively inorder to prevent post-operative sequeale. We anatomists submit that awareness of variations of splenic artery branching pattern as described in the current report would contribute to minimise vascular complications during abdominal surgeries.

Conflict of Interest

None.

Source of Funding

None.