IJCRR - Vol 06 Issue 18, September, 2014
STUDY ON ORIGIN, COURSE, BRANCHING PATTERN AND MORPHOMETRY OF SPLENIC ARTERY AND ITS BRANCHES SUPPLYING THE SPLEEN-A CADAVERIC STUDY
Author: Gangadhara, Rajasekhar P., Hemasankar C.
Objectives: 1.To measure the length of splenic artery and its branches supplying the spleen till they enter the hilum. 2. To note the origin and course of the splenic artery. 3. To note type of branching pattern of the splenic artery and occurrence of polar artery. Methods: Splenic artery & its branches supplying spleen were dissected neatly, traced till the hilum and measured with the digital vernier calliper. Other branches of splenic artery were not considered in the study. Results: Mean length of the splenic artery trunk was 7.45cms (Range: 2-11cm), lobar artery 3.24cms (Range: 1.2-8cms), segmental artery 1.21cms (Range: 0.4- 3cms), trabecular artery 0.59cm (Range: 0.3-2.5cms). The splenic artery trunk was bifurcated in 80 %( 24), trifurcated in 16.66 % ( 5) and quadrifurcated in 3.3 %( 1). Lobar artery was bifurcated in 63.33%, trifurcated in 33.33% and quadrifurcated in 3.33%. Segmental artery was bifurcated in 93.33% and trifurcated in 6.66%. In All the specimens the splenic artery was arising from coeliac trunk. 63.3 %( 19) of specimens showed supra-pancreatic course and 36.6 % (11) showed retro-pancreatic course of splenic artery. 26.6 %( 8) of specimens showed only superior polar artery, 36.6 %( 11) showed only inferior polar artery, 16.6 %( 5) showed both polar arteries and 20 %( 6) of specimens has no polar artery. Conclusions: knowledge of vascular supply for the spleen is very important for the surgeons during partial resections of spleen and it is also important for radiologist for performing preoperative arteriography and splenic artery embolization..
Keywords: Spleen, Splenic artery, Splenic segments, Partial splenectomy, Splenic artery thromboembolism
Gangadhara, Rajasekhar P., Hemasankar C.. STUDY ON ORIGIN, COURSE, BRANCHING PATTERN AND MORPHOMETRY OF SPLENIC ARTERY AND ITS BRANCHES SUPPLYING THE SPLEEN-A CADAVERIC STUDY International Journal of Current Research and Review. Vol 06 Issue 18, September, 16-23
1. Susan Standring. Gray’s Anatomy, The Anatomical Basis of Clinical Practice.40th ed. Elsevier Churchill Livingstone Publications; 2008: 1116-1117, 1193
2. Petroinu A. O Baco. 1st edi Sao Paulo: CLR Balseiro; 2003
3. Liana Ferreira Alencar Silva, Lívia Mara Almeida Silveira, Paula Sátiro Timbo, Sanna Roque Pinheiro, Larissa Vasconcelos Barros, Antonio Ribeiro da Silva Filho,TCBC-CE.Morfometric study of arterial branching of spleen compared to radiological study. Rev. Col. Bras. Cir. 2011; 38(3): 181-185
4. Datta AK. Essentials of human embryology. 4th edi. Current books international; 2007: 185, 192-193
5. Morita M. Reports and Conception of 3 anomalous cases of the celiac andsuperior mesenteric arteries. Igaku Kenkyu. 1935; 9: 1993-2006 cited by AkiraImura, Takeshi Oguchi, Masakazu Shibata, Tsuneo Takahasi. An Anomalouscase of the hepatic artery arising from the superior mesenteric artery. OkajimasFolia Anat. Jpn. Aug 2007; 84(2): 64-66
6. Oh E, Gross BH, Williams DM. Independent origin of the hepatic and splenicarteries from abdominal aorta: CT demonstration. J Comput Assist Tomogr.1998 Jul-Aug; 22(4): 669-70.
7. Fligashi N, Hirai K. A case of three branches of celiac trunk arising directly from the abdominal aorta. Kaibogaku Zasshi. 1995 Aug; 70(4): 349-52.
8. Yamaki K, Tanaka N, Matsushima T, Miyazaki, Yoshizuka M. A rare case of absence of celiac trunk: the left gastric, the splenic, the common hepatic and the superior mesenteric arteries arising independently from abdominal aorta. Ann Anat. 1995; 177(1): 97-100.
9. Sridhar Varma K, Pamidi N, Vollala VR, Bolla SR. Hepatospleno-mesentric trunk: A case report. Rom J Morphol Embryol. 2010; 51(2):401-2
10. Losanoff JE, Millis JM, Harland RC, Testa G. Hepato-spleno-mesentric trunk. J Am Coll Surg. 2007 Mar;204(3):511 Epub 2006 Sep 26.
11. Chen H, Yano R, Emura S, Shoumura S. Anatomic variation of the celiac trunk with special reference to hepatic artery patterns. Ann Anat. Oct 2009; 191(4):399-407.
12. Pandey SK, Bhattacharya S, Mishra RN, Shukla VK. Anatomical variations of the splenic artery and its clinical implications. Clin Anat. 2004; 17: 497-502.
13. Ashok KR. Study of origin, course and branching pattern of splenic artery with its variations and clinical implications. Dissertation submitted to the rajiv Gandhi university of health sciences, Bangalore Karnataka. 2010; 41-57
14. G.J.Romanes. Cunningham’s text book of anatomy, 12th edi, Oxford medical publications; 924-925. 15. A.Lee Mc grego. Synopsis of surgical anatomy, 12th edi. Wright and Varghese company; 1999. 110-111
16. Keith.L.Moore, Aurthur F.Dally. clinically oriented anatomy, 5th edi. Lipponcott Williams and wilkins, a wolter kluver company; 284
17. T.S. Ranganathan. A text book of human anatomy. S chand and company limited; 2006: 282-83
18. Courtney M.Townsend, R.Daniel Beauchamp, B Mark Evers, Kenneth L.Mattox. Sabiston text book of surgery. The Biological Basis of Modern Surgical Practice, 19th edi, Vol II. Elseveir Saunders; 1548
19. Charles J. Yeo, Jeffrey B.Mathews, David W.Mc fadden, John H.Pemberton, Jeffrey H.Peters. Shackelford’s Surgery of the Alimentary tract, 7th edi, Vol II. Elsevier Saunders; 1611-12.
20. Muzaffer Sindel, Levent Sarikcioglu, Kagan Ceken, Saim Yilmaz. The importance of the anatomy of the splenic artery and its branches in splenic artery embolization. Folia Morphol. Vol. 60,(4); 2001: 333.336
21. Norman.S.Williams, Christopher J.K.Bulstrode , P Ronan O’ Connel. Bailey and love’s Short practice of surgery, international 26th edition. CRC Press-Publishers; 2013: 1087.
22. Josef E Fischer, Daniel B Jones, Frank B Pomposelli, Gilbert R Upchurch, V Suzanne Klimberg, Steven D Schwaitzberg, Kirby I Bland.Fischer’s Mastery of surgery, 6th edition,Volume II.Volter Kluver/Lipponcott Williams and Wilkins; 1853-55
23. Daisy Sahni A, Indarjit B, Gupta CN, Gupta FM, Harjeet E. Branches of the splenic artery and splenic arterial segments. Clin Anat. 2003; 16(5); 371-7.
24. Karl H. Treutner, Bernd Klosterhalfen, Gerd Winkeltau, Slyvia Moench, Volker Schumpelick. Vascular Anatomy of the Spleen: The Basis of Organ – Preserving surgery. Clin Anat. 1993; 6: 1-8.
25. Katritsis E, Parashos A, Papadopoulos N. Arterial segmentation of the human spleen by postmortem angiograms and corrosion casts. Angiology. 1982 Nov;33(11): 720-7
26. Sow ML, Dia A, Ouedraogo T. Anatomic basis for conservative surgery of the spleen. Surg Radiol Anat. 1991; 13(2): 81-7.
27. Charles Brunicardi F, Dana K. Anderson, Timothy R.Billiar, David L.Dunn, John G.Hunter, Jeffrey B.Mathews, Raphael E.Pollock. Schwartz’s Principles of Surgery. 9th ed. Mcgraw Hill Companies, Inc; 2010: 1247-49.
28. XU Wei-li, LI Suo-lin, WANG Yan, SHI Bao-jun, LI Meng, LI Ying-chao, ZHONG Zhi-yong and LI Zhen-dong. Laparoscopic splenectomy: color Doppler flow imaging for preoperative evaluation. Chinese Medical Journal.2009; 122(10): 1203-1208
29. Michels NA. The variational anatomy of the spleen and splenic artery. Am J Anat. 1942; 70: 21
30. JA Garcia Porrero, A Lemes. Arterial segmentation and subsegmentation in the human spleen. Acta Anat. 1988; 131: 276-283.
31. Mikhail Y Kamd, Nawar R, Rafla. Observation on the mode of termination and parenchymal distribution of splenic artery with evidence of splenic lobation and segmentation. J Anat. 1979; 128: 253-258.
32. Jauregui E. Anatomy of splenic artery. Rev Fac Cien Med Univ Nac Cordoba. 1999; 56(1): 21-41.
33. Shashikala Ramachandra londhe. Study of vascular pattern in human spleen. Dissertation submitted to Shivaji University Kolhapur. 2002: 19-22, 34, 35.