The Arterial Supply of Pancreas: Clinical and Anatomical Correlation

Background:The main arterial blood supply to pancreas is provided by splenic, superior (SPDA) and inferior pancreaticoduodenal arteries (IPDA).These arteries are susceptible to anatomical variations which affect the outcome in various embolization and invasive techniques especially involved in management of GI bleed.Objective: The present study was performed with the objective of streamlining variations of the arterial pattern, classify them and to document the presence of accessory arteries which will aid in success of various surgical and radiological interventions. Methods:The study was conducted on 23 formalin fixed adult human cadavers during routine dissection meant for educational purposes, conducted over a period of 3 years in the Department of Anatomy, Lady Hardinge Medical College, New Delhi.The origin, course, the branching pattern of splenic as well as superior and inferior pancreaticoduodenal arteries were studied carefully. Results:The study found 1) normal pattern of SPDA & IPDA in 91.3% & 82.61% of cases 2) trifurcation of GDA into gastroepiploic artery, anterior and posterior SPDA in 4.35% cases 3) origin of right gastroepiploic artery from the anastomotic junction of SPDA &IPDA in 4.35% cases.4) Multiple IPDA branches & 1st Jejunal branch from a short arterial stump in 13.04% cases.5) Accessory artery from SMA along with IPDA in 4.35% of cases. Conclusions:The study has described the rare anatomic variants to enhance the expertise of the operating surgeons, the interventional radiologists to prevent the risk associated with hasty ligation of aberrant or the unusual artery.