Coeliac trunk

Unpaired trunk · Foregut T5–T9

First unpaired ventral branch, arising at T12/L1 just below the aortic hiatus and running only 1–2 cm before trifurcating into left gastric, splenic and common hepatic arteries. Artery of the foregut: abdominal oesophagus to the major duodenal papilla, plus liver, gallbladder, pancreas and spleen.

Traced from the start

  1. Abdominal aorta
  2. Coeliac trunk

Detail

Level
T12 (upper border of L1), immediately below the median arcuate ligament
Supplies
Foregut: oesophagus, stomach, D1–D2 to papilla, liver, gallbladder, pancreas, spleen
Branches
Left gastric, splenic, common hepatic
Referred pain
Epigastrium, T5–T9 via greater splanchnic nerve

When it goes wrong

Median arcuate ligament of the diaphragm crosses and compresses the coeliac origin

Median arcuate ligament syndrome: thin young woman with postprandial epigastric pain 15–30 min after meals, weight loss and an epigastric bruit that varies with respiration; treated by laparoscopic release

Coeliac stenosis with a patent SMA

Foregut survives on retrograde flow through the pancreaticoduodenal arcade, which dilates and may form pancreaticoduodenal artery aneurysms

Practise this structure

1 question in the bank tagged Mesenteric Arterial Supply.