Origin of the Gastroduodenal Artery
The gastroduodenal artery is a branch of the common hepatic artery (answer c).
Anatomical Basis
The gastroduodenal artery (GDA) typically originates from the common hepatic artery, which is one of the three main branches of the celiac axis (along with the splenic artery and left gastric artery). This anatomical arrangement is considered the normal or standard configuration, present in approximately 75-80% of individuals 1.
Normal Arterial Anatomy
The vascular anatomy follows this pattern:
- The celiac axis arises from the anterior surface of the abdominal aorta
- The celiac axis divides into three branches:
- Left gastric artery
- Splenic artery
- Common hepatic artery
- The common hepatic artery then divides into:
- Gastroduodenal artery
- Proper hepatic artery (which further divides into right and left hepatic arteries)
Anatomical Variations
While the common hepatic artery origin is standard, anatomical variations do occur:
- In a study of 1000 cases, the normal anatomy (Type 1) was found in 75.7% of cases 2
- The remaining cases showed various arterial variations, but the gastroduodenal artery consistently originated from the common hepatic artery in the standard configuration
Clinical Significance
Understanding the origin of the gastroduodenal artery is critical for:
Surgical procedures: The GDA's position makes it vulnerable during hepatopancreaticobiliary surgeries due to its close relation to the first part of duodenum, common bile duct, and head of pancreas 1
Vascular interventions: Many interventional radiology procedures involve the GDA and its branches, requiring precise knowledge of its origin 3
Management of bleeding: The GDA can be a source of gastrointestinal hemorrhage due to true aneurysms or pseudoaneurysms 1
Transarterial procedures: Catheterization for chemoembolization or other interventions requires understanding of this anatomy 4
Anatomical Relationships
The gastroduodenal artery holds a unique anatomical position connecting the foregut and midgut arterial supplies 1. It gives rise to:
- Right gastroepiploic artery
- Superior pancreaticoduodenal artery
- Supraduodenal artery (typically)
In rare cases, the supraduodenal artery and right gastric artery may originate as a common trunk from the left hepatic artery rather than from the GDA and proper hepatic artery respectively 3.
Understanding this standard anatomy and its potential variations is essential for surgeons, interventional radiologists, and other specialists working in the upper abdomen.