Coeliac Artery

• Origin: Front of the Abdominal Aorta between the crura of the diaphragm
  • A little below the Median Arcuate Ligament
  • At the level of T12 vertebra body
  • Flanked by Coeliac group of Pre-Aortic Lymph Nodes
• Coeliac Ganglia lie one on each side – send sympathetic nerves carried along its branches
• Supplies: The GI tract from the lower part of the oesophagus down to the opening of the bile duct into the duodenum + Foregut derivatives (liver and pancreas) and the spleen
• Branches: Left Gastric Artery, Splenic Artery, and Common hepatic artery
• Course: Divides at the upper border of the Pancreas into three branches behind the peritoneum of the posterior wall of the Lesser Sac

1. Left Gastric Artery

• Course:
  • Runs upwards across the left crus to the oesophageal opening in the diaphragm
  • Gives off oesophageal branches
  • Turns antero-inferiorly raising a small fold of peritoneum, the Left Gastropancreatic Fold
  • Turns right in the Lesser Omentum along the Lesser Curvature
  • Supplies stomach
• Branches:
  • Oesophageal branches

2. Splenic Artery

• Course:
  • Passes to the left
  • Tortuous
  • Crests of its waves appear above the Pancreas
  • From the middle part, may give off a Posterior Gastric Artery to the stomach, which raises a fold of the parietal peritoneum called the Gastrosplenic Ligament, as it arches forwards towards the Stomach
  • Runs across the Left Crus and Left Psoas to the hilum of the Left Kidney
  • Turns forward in the Splenorenal Ligament to the hilum of the Spleen
  • Gives off 6 Short Gastric Arteries, which run in the Gastrosplenic Ligament
  • Gives off the Left Gastroepiploic Artery – runs to the right in the Greater Omentum
    • Gives branches to the Stomach and Omentum
  • Breaks up into terminal splenic branches
• Branches:
  • Posterior Gastric Artery
  • Short Gastric Arteries
  • Left Gastroepiploic Artery

3. Common hepatic artery Course

• Passes over upper border of pancreas
• Then downwards and to the right behind the peritoneum of the posterior abdominal wall (in the lesser sac) as far as the first part of the duodenum
• Turns forward at the opening into the lesser sac (epiploic foramen) and turns upwards into the space between the 2 layers of the lesser omentum
• Becomes the hepatic artery
  • Meets the bile duct
    • Lies on left side of bile duct
  • Both bile duct and hepatic artery are in front of the portal vein
  • All 3 lie between duodenum and porta hepatis surrounded by peritoneum at free edge of lesser omentum
  • NOTE: ‘Common hepatic’ becomes ‘hepatic proper’ as soon as it turns UPWARDS

Hepatic artery

• Reaches porta hepatis and divides:
  • Right hepatic artery – right half of liver
  • Left hepatic artery – left half of liver

Other branches

• Right gastric

  • Leaves common hepatic as it turns into lesser omentum to reach the stomach

• Gastroduodenal

  • Passes down behind first part of duodenum to the left of the portal vein
  • Then divides into 2
    • Right gastroepiploic artery
      • Passes forward between first part of duodenum and pancreas
      • Turns to the left to enter between the 2 leaves of the greater omentum at their attachment over the front of the head of the pancreas
    • Superior pancreaticoduodenal artery
      • Divides into 2 branches – encircle the head of the pancreas in the concavity of the duodenum down to the entrance of the bile duct
        • Anterior branch (small)
        • Posterior branch (large)
      • Both branches anastomose with similar branches of the ‘inferior pancreaticoduodenal branch’ (from SMA)
      • Bile duct entrance marks the junction of foregut/midgut – is the meeting place of the arterial distributions of the respective arteries (coeliac/SMA)
      • Pancreaticoduodenal arteries supply:
        • Duodenum
        • Adjacent head of pancreas

• Entrance of Bile Duct marks junction between Foregut and Midgut

  • Meeting place of the arterial distributions of the Coeliac and Superior Mesentery Arteries