Absence of the celiac trunk: The left gastric, the common hepatic, and the splenic arteries arising independently from the abdominal aorta: A case report

The celiac trunk is the first branch of the abdominal aorta which arises from the anterior surface of the abdominal aorta and usually extends 1-2 cm before it branches into 3 branch arteries: the left gastric artery, the common hepatic artery, and the splenic artery. It is essential to comprehend the intricate arterial branch anatomy of the abdominal aorta to carry out abdominal surgeries as well as interventional radiology procedures safely. A 63-year-old woman who had been experiencing right upper quadrant adnominal pain for 2 months along with weight loss and appetite presented to the surgical unit of Tikur Ambessa Hospital. On exams, her vital signs were stable. Her abdominal exams were unremarkable. She was evaluated with an abdominal ultrasound which detected a mass arising from the gallbladder. With the impression of gallbladder mass contrast-enhanced computed tomography was done and revealed a rare anatomic variant of the celiac artery where the celiac artery was absent and the left gastric, the common hepatic, and the splenic arteries arise independently from the abdominal aorta. Clinicians should be aware of the presence of rare arterial variations because these changes can have a variety of therapeutic implications when performing surgical procedures like liver transplant, celiac artery resection such as the Appleby procedure for pancreatic and stomach cancer, or during interventional radiology procedures like transarterial chemoembolization.