Prevalence of anatomical variations in the abdominal aorta and its branches on contrast-enhanced computed tomography

Introduction. Anatomical variations in the abdominal aorta and its branches are crucial for surgical and interventional planning. Unrecognized variants during preoperative evaluation can increase the risk of complications. The aim of this study was to determine the prevalence and types of these variations, as found on contrast-enhanced computed tomography (CECT) in a South Indian population, with attendant clinical relevance. Materials and methods. In this retrospective investigation, 5000 CECT abdomen images from patients at Saveetha Medical College in Chennai between January 2020 and December 2023 were examined. We examined variations of the abdominal aorta and its branches (celiac trunk, superior mesenteric artery [SMA], inferior mesenteric artery [IMA], and renal arteries) as the focus of this study. Variations were categorized and their prevalence was determined. The prevalence was statistically compared to national and international data, and the clinical significance of these variations was evaluated. Results. The study demonstrated anatomical variations in 32% of patients of the abdominal aorta and its branches. The most common variation was accessory renal arteries, measured in 12%. In 9% of patients, variations in the celiac trunk were found, the most frequent being hepatosplenic trunk, hepatogastric trunk, and celiomesenteric trunk. In 5%, the aorta presented SMA variation, in 3% IMA variation, and in 2% an abnormal bifurcation of the aorta. There was a slightly higher prevalence of certain variations, notably at the celiac trunk, in this South Indian cohort compared to national averages, pointing to environmental factors. Conclusion. This study underscores the importance of preoperative vascular mapping to identify anatomical variants of the abdominal aorta. Recognizing these variations – particularly prevalent in this regional population – can enhance surgical precision and reduce intraoperative complications. Region-specific imaging data such as this are essential to guide safe, individualized interventions.