Prehepatocholedochal Proper Hepatic Artery. Rare Anatomical Variant. Surgical Considerations. Case Report

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Prehepatocholedochal Proper Hepatic Artery. Rare Anatomical Variant. Surgical Considerations. Case Report

V. Ardeleanu, S. Chicoş, D. Tutunaru, C. Georgescu
Clinical case, no. 2, 2014
In classical anatomic variants, the proper hepatic artery (PHA)continues the common hepatic artery (CHA) after the gastroduodenal artery (GDA) detaches itself and divides into theright hepatic artery (RHA) and left hepatic artery (LHA), theproper hepatic artery being located to the left of the hepatocholedochalduct (HCD). This paper presents an abnormalpositioning of the PHA placed before the HCD with anincreased diameter of about 5-7 mm, which could be confusedwith the HCD. We present the case of a 57 year-old womandiagnosed with acute lithiasic cholecystitis, associated withhypersplenism and hypertension. The literature mentionsmanifold anatomical variants of arterial liver vascularization,including PHA. For this reason, this paper presents an overviewof similar cases that can be found in medical literature. Theaforementioned case is a rare topographic anatomy for thePHA that can easily pass for HCD especially duringcelioscopy, therefore it is crucial for this to be acknowledged byall surgeons.