Pentafurcation of Coeliac Trunk with Accessory Hepatic Arteries and Replaced Middle Colic Artery: A Cadaveric Case Report

The present report documents a rare case of Coeliac Trunk (CT) pentafurcation identified during routine cadaveric dissection in a male cadaver of approximately 60 years of age, with the CT giving rise to five distinct branches: the Left Gastric Artery (LGA), Common Hepatic Artery (CHA), Splenic Artery (SA), and both the Right and Left Inferior Phrenic Arteries (RIPA and LIPA). Additional notable arterial variations included the presence of accessory left and right hepatic arteries, as well as a replaced Middle Colic Artery (rMCA) originating from the SA, deviating from classical vascular anatomy. Such complex configurations carry significant clinical implications for hepatobiliary, pancreatic, and gastrointestinal surgery, where unexpected vascular routes can affect organ perfusion and complicate surgical intervention. Recognition of accessory hepatic and cystic arteries is particularly vital in procedures involving the porta hepatis and gallbladder, while aberrant mesenteric branching necessitates careful planning during colonic and pancreatic resections. Preoperative detection of these anomalies using advanced imaging modalities is crucial to mitigating intraoperative risks, preventing ischaemic complications, and optimising outcomes in transplantation and oncologic surgery. The present case underscores the necessity for heightened anatomical awareness and individualised operative strategies in the presence of rare vascular variants, thereby serving as a valuable reference for clinicians and anatomists striving for excellence in patient safety and surgical precision.