Illustrated Encyclopedia of Human Anatomic Variation: Opus II: Cardiovascular System: Arteries: Abdomen: Variations in Branches of Celiac Trunk

Splenic Artery

Ronald A. Bergman, PhD
Adel K. Afifi, MD, MS
Ryosuke Miyauchi, MD
Peer Review Status: Internally Peer Reviewed

The variations of the splenic artery are numerous. It may divide into two branches that reunite, the splenic vein passing through the loop thus formed. It may give rise to branches normally derived from other vessels, such as the left gastric, middle colic, and left hepatic.

The splenic artery supplies four to six (more or less) gastric vasa brevia arteries. These are terminal or end arteries. It can arise from the gastroepiploic artery, the splenic artery proper, the splenic branches of the splenic artery, or any combination thereof. The left gastroepiploic artery may originate from one of the splenic branches, rather than from the splenic artery proper.

The dorsal pancreatic artery arises from the splenic in 37% of cases, the celiac in 33%, the superior mesenteric in 21%, and the common hepatic artery in 8%, typically close to the aortic source.

As indicated in a previous section (celiac trunk), the celiac trunk may lack one or more of its main branches. In such cases, the branch in question may arise from the aorta or the superior mesenteric, either independently or in conjunction with another branch. Variations have been reported to occur with the following frequencies (approximate):

1) Hepatosplenogastric trunk; usual complement 90%.
2) Hepatosplenic trunk (hepatic and splenic) 3.5%.
3) Hepatosplenomesenteric trunk (hepatic, splenic, and superior mesenteric) 0.5%.
4) Hepatogastric trunk (hepatic and left gastric) 1.5%.
5) Splenogastric trunk (splenic and left gastric) 5.5%.
6) Celiacomesenteric trunk (superior mesenteric in conjunction with hepatosplenogastric trunk) 1.2-2.5%.
7) Celiacocolic trunk; middle or accessory middle colic arising from the celiac trunk is extremely rare (no frequency data is available).

The splenic and hepatic arteries have been described arising from a common trunk from the superior mesenteric artery. Krause (see Henle) reported a case of Hyrtl's in which the splenic arose from the superior mesenteric. The splenic artery has been shown to give rise to the hepatic artery, which joined the superior mesenteric artery and then branched from the superior mesenteric artery to supply the liver.

The inferior pancreatic artery may also supply the spleen.

The tortuous course of the splenic artery is considered so variable that no two arteries are alike, but the tortuosity of the artery is absent in infants and children.

The splenic vein is not invested in a common sheath with the artery - it is retropancreatic and never tortuous.

Splenic arteries are end-arteries in the strictest sense, and interference with the blood supply to the spleen will result in necrotic areas in the organ.

The splenic artery may course through the pancreas to reach the spleen. In congenital absence of the spleen (very rare), the splenic artery terminates in the pancreas.

Variant branches of the splenic artery:
The posterior gastric artery is a branch of the splenic and it is present 48 to 67.8% of individuals; DiDio et al. found it in 46% of their subjects. According to DiDio, the surgical importance of the posterior gastric artery derives from its relatively high incidence, from its being another source of the blood supply to the superior portion of the posterior gastric wall and from having an almost hidden origin (from behind the splenic artery). In addition, it supplies a superior polar to the spleen. It is important for the surgeon to know of the existence of this cranially directed branchs of the splenic artery to the posterior gastric wall and the superior pole of the spleen and of their variations. These vessels have a "hidden" posterior location and may be overlooked leading to the possibility of dangerous bleeding if damaged. The posterior gastric artery was first described by Walther in 1729.

The splenic artery has been shown to give rise to esophageal arteries.

Image 101, Image 183, Image 269

Superior

Image 430

Middle Colic

See Image 101

Posterior Gastric

See Image 430

Dorsal Pancreatic

See Image 101

Superior (Splenic), Superior Polar (Splenic)

See Image 269

Posterior Superior Pancreatoduodenal

Image 341

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