Coeliac Trunk

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The coeliac trunk, also known as the celiac artery, is a major branch of the abdominal aorta.
It typically originates around the level of the T12 vertebra, immediately below the aortic hiatus of the diaphragm.

The coeliac trunk is relatively short, usually about 1.25 cm in length, and travels anteriorly towards the lesser curvature of the stomach.
It quickly trifurcates into three main branches: the left gastric artery, the common hepatic artery, and the splenic artery.

Left Gastric Artery: smallest of the three branches, travels towards the lesser curvature of the stomach. It may give off oesophageal branches.
Common Hepatic Artery: usually runs to the right and upward. It typically gives off the proper hepatic artery (to the liver) and the gastroduodenal artery (to the stomach and first part of the duodenum).
Splenic Artery: the largest branch, follows a tortuous course towards the spleen, giving off multiple pancreatic branches and short gastric arteries along its course.

The coeliac trunk provides blood supply to the foregut derivatives which include:

Stomach: Both the left gastric artery and branches of the common hepatic artery (like the right gastric artery and gastroduodenal artery) contribute to the stomach’s blood supply. While it’s difficult to quantify exactly, these arteries cover the majority of the stomach’s blood supply.
Liver: The proper hepatic artery, a branch of the common hepatic artery, supplies about 75% of the liver’s blood supply. The remaining 25% is from the portal vein which carries nutrient-rich blood from the gut.
Spleen: The splenic artery is the sole supply to the spleen.
Pancreas: The splenic artery provides significant supply to the body and tail of the pancreas via multiple pancreatic branches. The head of the pancreas is primarily supplied by branches of the gastroduodenal artery.
Duodenum: The superior part of the duodenum is supplied by the gastroduodenal artery.

Superior: lesser omentum and stomach
Inferior: pancreas lies on the horizontal part of the duodenum and the left renal vein
Anterior: lesser sac of the peritoneal cavity, lesser omentum, stomach
Posterior: crura of the diaphragm, left adrenal gland, upper part of left kidney, and the commencement of the superior mesenteric artery

Variations in the coeliac trunk branching pattern are relatively common.

Trifurcation (Normal, occurs in ~70% of people): coeliac trunk gives off the left gastric, common hepatic, and splenic arteries.
Bifurcation (~15%): coeliac trunk bifurcates into splenic and a common hepato-gastric trunk.
Hepatosplenic Trunk (~7.5%): coeliac trunk bifurcates into a common hepatic artery and a lienogastric trunk (combining splenic and left gastric arteries).
Gastrosplenic Trunk (~5%): coeliac trunk bifurcates into a common hepatic artery and a hepatogastric trunk (combining hepatic and left gastric arteries).
Absence of Coeliac Trunk (~2.5%): the arteries typically arising from the coeliac trunk instead arise directly from the abdominal aorta.

Updated on 19 June 2023