Coeliac trunk
Branch · T12 Foregut 3 branches
Short, wide unpaired trunk from the front of the aorta at T12, just below the aortic hiatus, dividing almost at once into the left gastric, splenic and common hepatic arteries. Supplies the foregut: abdominal oesophagus, stomach, duodenum to the major papilla, liver, gallbladder, pancreas and spleen.
Traced from the start
- Abdominal aorta
- Coeliac trunk
Detail
- Level
- T12
- Branches
- Left gastric, splenic, common hepatic
- Relations
- Surrounded by the coeliac plexus and ganglia; runs above the upper border of the pancreas; the median arcuate ligament of the diaphragm arches over its origin
- Collaterals
- Pancreaticoduodenal arcades link the gastroduodenal artery to the SMA
When it goes wrong
Median arcuate ligament syndrome (the ligament compresses the trunk, worse on expiration)
Post-prandial epigastric pain, weight loss and an epigastric bruit in a thin young patient
Atheromatous occlusion of the coeliac trunk
Often silent because the pancreaticoduodenal arcades bring SMA blood back to the foregut; chronic mesenteric ischaemia usually needs two of the three visceral trunks diseased
Coeliac plexus block for intractable pancreatic cancer pain
Neurolysis around the trunk at T12/L1 removes foregut visceral pain; orthostatic hypotension and diarrhoea from sympathetic loss
Practise this structure
1 question in the bank tagged Mesenteric Arterial Supply.