{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T19:36:17Z","timestamp":1794080177209,"version":"4.8.0"},"reference-count":29,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:00:00Z","timestamp":1613347200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>The rare anatomic variants of the celiac trunk and superior mesenteric artery include the hepatosplenic, hepatosplenomesenteric (HSMT), celiacomesenteric, hepatomesenteric and gastrosplenic trunks. We report a 72-year-old female patient whose computed tomography angiograms indicated a rare anatomic feature whereby the right inferior phrenic artery was inserted in the origin of an HSMT, thus modifying it into a hepatosplenomesentericophrenic trunk (HSMPT). Above the HSMPT, the insertion of the left inferior phrenic artery in the origin of the left gastric artery determined a left gastrophrenic trunk (GPT). Proper identification of this type of rare anatomic variant is of utmost importance prior to different surgical procedures. For example, an HSMT origin of the right inferior phrenic artery is surgically relevant if this artery is an extrinsic pedicle of a hepatocellular carcinoma and is used for embolization of the tumor.<\/jats:p>","DOI":"10.3390\/medicina57020170","type":"journal-article","created":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T02:34:45Z","timestamp":1613356485000},"page":"170","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Rare Anatomic Variation: The Hepatosplenomesentericophrenic Trunk"],"prefix":"10.3390","volume":"57","author":[{"given":"Bogdan Gheorghe","family":"Hogea","sequence":"first","affiliation":[{"name":"Department of Orthopaedic &amp; Trauma Surgery, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8723-0540","authenticated-orcid":false,"given":"Mugurel Constantin","family":"Rusu","sequence":"additional","affiliation":[{"name":"Division of Anatomy, Faculty of Dental Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4238-7253","authenticated-orcid":false,"given":"Adelina Maria","family":"Jianu","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Embryology, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan Adrian","family":"Manta","sequence":"additional","affiliation":[{"name":"Division of Anatomy, Faculty of Dental Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian Cosmin","family":"Ilie","sequence":"additional","affiliation":[{"name":"Division of Public Health and Management, Faculty of Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1007\/s00276-019-02286-9","article-title":"Unusual anatomical variation: Tetrafurcation of the celiac trunk","volume":"41","author":"Damen","year":"2019","journal-title":"Surg. Radiol. Anat."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.aanat.2013.06.003","article-title":"Variations in the anatomy of the celiac trunk: A systematic review and clinical implications","volume":"195","author":"Panagouli","year":"2013","journal-title":"Ann. Anat. Anat. Anz."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1002\/ca.23576","article-title":"Variations of the celiac trunk investigated by multidetector computed tomography: Systematic review and meta-analysis with clinical correlations","volume":"33","author":"Whitley","year":"2020","journal-title":"Clin. Anat."},{"key":"ref_4","first-page":"123","article-title":"The clinical relevance of coeliac trunk variations","volume":"64","author":"Gielecki","year":"2005","journal-title":"Folia Morphol."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Juszczak, A., Mazurek, A., Walocha, J.A., and Pasternak, A. (2020). Celiac trunk and its anatomic variations: Cadaveric study. Folia Morphol.","DOI":"10.5603\/FM.a2020.0042"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Lippert, H., and Pabst, R. (1985). Arterial Variations in Man: Classification and Frequency, J.P. Bergmann Verlag.","DOI":"10.1007\/978-3-642-80508-0"},{"key":"ref_7","unstructured":"Michels, N.A. (1955). Blood Supply and Anatomy of the Upper Abdominal Organs with a Descriptive Atlas, Lippincott."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1148\/radiol.09090389","article-title":"Celiac Axis and Common Hepatic Artery Variations in 5002 Patients: Systematic Analysis with Spiral CT and DSA","volume":"255","author":"Song","year":"2010","journal-title":"Radiology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"336","DOI":"10.3348\/kjr.2017.18.2.336","article-title":"Variations in the Origin of Inferior Phrenic Arteries and Their Relationship to Celiac Axis Variations on CT Angiography","volume":"18","author":"Aslaner","year":"2017","journal-title":"Korean J. Radiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1002\/ca.22204","article-title":"Common stem origin of left gastric, right and left inferior phrenic arteries, in association with a hepatosplenomesenteric trunk, independently arising from the abdominal aorta: Case report using MDCT angiography","volume":"26","author":"Matusz","year":"2012","journal-title":"Clin. Anat."},{"key":"ref_11","first-page":"56","article-title":"Hepato-gastro-phrenic trunk and hepato-spleno-mesenteric trunk: A rare anatomic variation","volume":"32","author":"Hemanth","year":"2011","journal-title":"Trop. Gastroenterol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Tubbs, R.S., Shoja, M.M., and Loukas, M. (2016). Bergman\u2019s Comprehensive Encyclopedia of Human Anatomic Variation, John Wiley & Sons, Inc.","DOI":"10.1002\/9781118430309"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"567.e1","DOI":"10.1016\/j.avsg.2020.08.007","article-title":"Pentafurcated Celiac Trunk","volume":"70","author":"Rusu","year":"2021","journal-title":"Ann. Vasc. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"\u0218elaru, M., Rusu, M.C., Jianu, A.M., B\u00eers\u0103\u0219teanu, F., and Manta, B.A. (2020). Hepatomesenteric trunk, gastrosplenic trunk, coiled splenic and hepatic arteries, and a variant of B\u00fchler\u2019s arc. Folia Morphol.","DOI":"10.5603\/FM.a2020.0136"},{"key":"ref_15","first-page":"150","article-title":"CT angiography of the celiac trunk: Anatomy, variants and pathologic findings","volume":"17","author":"Ozbulbul","year":"2010","journal-title":"Diagn. Interv. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1002\/ca.22136","article-title":"A morphometric study of the celiac trunk and review of the literature","volume":"26","author":"Venieratos","year":"2012","journal-title":"Clin. Anat."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1007\/BF02300762","article-title":"\u00dcber die Variet\u00e4ten der Arteria coeliaca und deren Entwickelung","volume":"25","author":"Tandler","year":"1904","journal-title":"Anat Hefte"},{"key":"ref_18","unstructured":"Adachi, B. (1928). Das Arteriensystem der Japaner, Maruzen Company. [2nd ed.]."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1007\/s00276-008-0324-7","article-title":"Multidetector-row CT angiographic imaging of the celiac trunk: Anatomy and normal variants","volume":"30","author":"Iezzi","year":"2008","journal-title":"Surg. Radiol. Anat."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.aanat.2009.05.002","article-title":"Anatomic variation of the celiac trunk with special reference to hepatic artery patterns","volume":"191","author":"Chen","year":"2009","journal-title":"Ann. Anat. Anat. Anz."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1259\/bjr\/21236482","article-title":"Anatomical variations of hepatic arterial system, coeliac trunk and renal arteries: An analysis with multidetector CT angiography","volume":"83","author":"Battal","year":"2010","journal-title":"Br. J. Radiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1002\/ca.20112","article-title":"Clinical anatomy of the inferior phrenic artery","volume":"18","author":"Loukas","year":"2005","journal-title":"Clin. Anat."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/S0899-7071(02)00553-3","article-title":"The origin of right inferior phrenic artery on multidetector row helical CT","volume":"27","author":"Hiwatashi","year":"2003","journal-title":"Clin. Imaging"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Whitley, A., K\u0159e\u010dek, J., and Kachl\u00edk, D. (2021). The inferior phrenic arteries: A systematic review and meta-analysis. Ann. Anat. Anat. Anz., 151679.","DOI":"10.1016\/j.aanat.2021.151679"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"189","DOI":"10.2739\/kurumemedj.47.189","article-title":"An Anomalous Case of the Hepato-spleno-mesenteric and the Gastro-phrenic Trunks Independently Arising from the Abdominal Aorta","volume":"47","author":"Hirai","year":"2000","journal-title":"Kurume Med. J."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Rusu, M.C., Jianu, A.M., Dinc\u0103, D., and Manta, B.A. (2020). Quadrifurcation Variants of the Celiac Trunk. Ann. Vasc. Surg.","DOI":"10.1016\/j.avsg.2020.11.016"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Mazurek, A., Juszczak, A., Walocha, J.A., and Pasternak, A. (2020). Rare combined variations of the celiac trunk, accessory hepatic and gastric arteries with co-occurrence of double cystic arteries: A case report. Folia Morphol.","DOI":"10.5603\/FM.a2020.0052"},{"key":"ref_28","first-page":"77","article-title":"Rare variations in the Origin, Branching Pattern and Course of the Celiac Trunk: Report of Two Cases","volume":"23","author":"Prasanna","year":"2016","journal-title":"Malays. J. Med. Sci. MJMS"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1148\/rg.273065036","article-title":"Inferior Phrenic Artery: Anatomy, Variations, Pathologic Conditions, and Interventional Management1","volume":"27","author":"Gwon","year":"2007","journal-title":"Radiographics"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/57\/2\/170\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:24:14Z","timestamp":1760160254000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/57\/2\/170"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,15]]},"references-count":29,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2]]}},"alternative-id":["medicina57020170"],"URL":"https:\/\/doi.org\/10.3390\/medicina57020170","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,15]]}}}