Arteria Gastrica
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Arteria Gastrica
Arteria gastrica sinistra probíhá v peritoneální plica gastropancreatica, která je uložena na zadní stěně peritoneální dutiny. Z truncu odstupuje směrem doleva a mírně ventrálně, následně se stáčí podél curvatura minor žaludku, kde anastomózuje s arteria gastrica dextra.
Arteria hepatica propria vysílá kaudálně na úrovni pyloru arteria gastrica dextra, která pak dále pokračuje podél curvatura minor, kde anastomosuje s arteria gastrica sinistra. Samotná a. hepatica propria dále běží horizontálně doprava směrem k játrům, cestou vysílá a. cystica. Jakmile dorazí k porta hepatis, rozdělí se na dvě větve. Ty společně s větvemi veny portae míří do pravého a levého jaterního laloku.
Arteria gastroduodenalis je krátká, ale tlustá větev. Sestupuje poblíž pyloru ventrálně od hlavy pankreatu. Na tomto místě se rozdělí na své tři větve. Nejdříve jsou to aa. retroduodenales shora na zadní stranu duodena. Arteria gastroepiploica dextra pokračuje nalevo podél curvatura major žaludku a anastomosuje s arteria gastroepiploica sinistra.Arteria pancreaticoduodenalis superior sestupuje na rozhraní pancreatu a duodena. Dělí se zde na ventrální a posteriorní větev, přičemž obě tyto větve tvoří anastomosu s arteria pancreaticoduodenalis inferior (z a. mesenterica superior).
OBJECTIVES: to demonstrate the minutiae of hepatic arterial system, the incidence of anatomical variations and to compare data obtained from the literature, thus contributing with students and professionals working in this area. METHODS: We prepared 45 corpses at the Department of Anatomy of the Pontifical Catholic University of Paraná, between July 2010 and April 2011, of which group 30 displayed integrity of structures. We analyzed the anatomical variations of the hepatic arteries, their main characteristics, such as origin, course, length and diameter. The overall result was expressed as frequency and percentage of cadavers with anatomic variations of the hepatic arterial system. The estimative of this percentage was done by constructing a confidence interval of 95%. RESULTS: There was some kind of anatomical variation in 40% (n = 12) of cadavers. We found 02 variations in the common hepatic artery, 03 in the gastroduodenal artery, 03 in the right hepatic artery, 01 in the left hepatic artery, 01 in the right gastric artery, and 02 in cystic artery. As for the celiac artery, there were variations in length, diameter and height in its origin, which was common on the aorta. The variation of right hepatic artery originating from the superior mesenteric artery was found in 10% (n = 3) of the specimens studied and it was considered the most prevalent type of variation in this study. CONCLUSION: Changes in hepatic arteries are frequently found and in this study their incidence was 40%, similar to the literature. The most significant change, observed in 10% (3 cases), was the right hepatic artery with its origin in the superior mesenteric artery.
Conforme descrito por ilustres anatomistas, como Testut, Moore, Sobotta e Netter, a anatomia da artéria hepática se dá quando o tronco celíaco com origem na aorta ramifica-se em artéria gástrica esquerda, artéria esplênica e artéria hepática comum. Esta última, após a emergência da artéria gastroduodenal, continua-se como artéria hepática própria e ramifica-se em artéria hepática direita e esquerda no hilo hepático2-5. Esta configuração é a adotada pela maioria dos estudiosos do tema, destacamos Michels et al. e Soin et al.6,7. Segundo a literatura, variações neste sistema arterial ocorrem aproximadamente entre 25 e 42%. Bertevello et al. e Soares et al. descreveram ainda casos raros de variações, dentre eles citamos artéria hepática dupla; artéria hepática direita da artéria mesentérica inferior; artéria hepática passando por trás da veia porta8,9.
O objetivo deste estudo foi dissecar e estudar em cadáveres humanos as minúcias do sistema arterial hepático, a incidência das variações anatômicas e comparar os dados obt