A Rare Case of Tripartite Hepatic Arterial Supply from the Left Gastric and Superior Mesenteric Arteries

Anatomic variations of the hepatic artery are common; however, complex configurations with multiple independent origins are rare. We report an unusual case of a tripartite hepatic arterial supply identified during angiography in a 63-year-old man with hepatocellular carcinoma. The left hepatic artery originated from the left gastric artery and supplied segments 2 and 3. The superior mesenteric artery gave rise to two independent hepatic arteries: a replaced common hepatic artery supplying the gastroduodenal artery and segment 4, and a replaced right hepatic artery supplying segments 5 to 8. The celiac trunk had no direct hepatic branches. This configuration likely reflects the persistence of embryonic ventral splanchnic arterial channels. Recognition of such variants is essential for accurate angiographic interpretation and safe planning of hepatobiliary surgery and transarterial interventions.