Common hepatic artery

Sub-branch · Gastroduodenal a. Proper hepatic a.

Passes right along the upper border of the pancreas to the first part of the duodenum, where it gives off the gastroduodenal artery and continues as the proper hepatic artery in the free edge of the lesser omentum (left of the bile duct, in front of the portal vein) to the porta hepatis.

Traced from the start

  1. Abdominal aorta
  2. Coeliac trunk
  3. Common hepatic artery

Detail

Branches
Gastroduodenal (→ right gastro-omental, superior pancreaticoduodenal); proper hepatic (→ right gastric, right and left hepatic; cystic artery usually from the right hepatic)
Supplies
Liver, gallbladder, stomach (both curvatures), duodenum and head of pancreas
Collaterals
Superior pancreaticoduodenal anastomoses with the inferior pancreaticoduodenal from the SMA

When it goes wrong

Posterior duodenal ulcer (first part) eroding through the wall

Torrential haematemesis and melaena from the gastroduodenal artery lying directly behind the duodenal bulb; endoscopic clipping or embolisation

Pringle manoeuvre (clamping the free edge of the lesser omentum)

Occludes the hepatic artery and portal vein together and arrests inflow bleeding from the liver; continued bleeding points to a hepatic vein or IVC source

Dissection of Calot's triangle at cholecystectomy

The cystic artery is found here, usually from the right hepatic; a replaced right hepatic artery from the SMA (about 15%) runs behind the bile duct and is at risk

Practise this structure

1 question in the bank tagged Mesenteric Arterial Supply.