The celiac artery, often called the celiac trunk, is a major blood vessel supplying the abdominal organs responsible for digestion and metabolism. This short, wide artery serves as the primary source of oxygenated blood for the entire foregut, including the upper gastrointestinal tract and associated solid organs. Its unique anatomical position and immediate branching pattern establish a central hub for arterial distribution in the upper abdomen.
Anatomical Position and Origin
The celiac artery originates directly from the anterior wall of the abdominal aorta. Its emergence occurs at a high point in the abdomen, typically at the level of the T12 vertebral body, just below the diaphragm, the muscular sheet separating the chest and abdominal cavities. The artery is short, usually measuring only 1 to 2 centimeters in length before it divides. As it leaves the aorta, the artery passes behind the median arcuate ligament, a fibrous band of tissue associated with the diaphragm.
The Three Primary Branches
Almost immediately after its origin, the celiac artery divides into three major terminal vessels, establishing the primary routes for blood distribution to the foregut structures. These three branches are the Left Gastric Artery, the Splenic Artery, and the Common Hepatic Artery. The Left Gastric Artery is usually the smallest, ascending upward and toward the left. The Splenic Artery is the largest branch, taking a tortuous path along the superior border of the pancreas, while the Common Hepatic Artery courses toward the right side of the abdominal cavity.
Supply Territories of the Foregut
Common Hepatic Artery
The Common Hepatic Artery distributes blood to the liver, gallbladder, and structures around the duodenum and pancreas. After giving off the gastroduodenal artery, it continues as the proper hepatic artery, which then branches into the right and left hepatic arteries to supply the capillary network of the liver. The proper hepatic artery also gives rise to the cystic artery, which supplies the gallbladder, and the right gastric artery, which supplies the pylorus and lesser curvature of the stomach.
Gastroduodenal Artery
The gastroduodenal artery, a branch of the common hepatic, extends the supply to the upper digestive tract. It forms the superior pancreaticoduodenal artery, which supplies the head of the pancreas and the proximal duodenum. This artery creates an important vascular connection with the superior mesenteric artery, forming an arterial arcade that allows for collateral blood flow.
Splenic Artery
The Splenic Artery’s main destination is the spleen, but it also supplies several other organs through its complex path. It gives off numerous branches that supply the body and tail of the pancreas as it runs along the organ’s surface. The artery also provides the short gastric arteries, which supply the fundus of the stomach, and the left gastroepiploic artery, which supplies a large portion of the stomach’s greater curvature.
Left Gastric Artery
The Left Gastric Artery is dedicated primarily to the stomach and esophagus. It supplies the lesser curvature of the stomach, running along its superior margin. It also sends branches upward to provide blood flow to the abdominal portion of the esophagus.
Clinical Relevance of Celiac Artery Issues
Disorders involving the celiac artery can have significant consequences, although a robust collateral system often mitigates severe symptoms. One specific condition is Median Arcuate Ligament Syndrome (MALS), which occurs when the median arcuate ligament compresses the celiac artery at its origin. This compression can restrict blood flow and may cause post-meal abdominal pain in some patients, though many remain asymptomatic.
The celiac artery system is also a site for aneurysm formation, an abnormal ballooning of the vessel wall. Aneurysms are especially common in the splenic artery, the most frequently affected vessel among the abdominal arteries. Furthermore, stenosis or blockage of the celiac artery can trigger the development of extensive collateral circulation, notably through the pancreaticoduodenal arcades. This mechanism reroutes blood from the superior mesenteric artery to the celiac artery’s branches to prevent organ ischemia.