Left gastric, splenic and common hepatic arteries
Mnemonic
“Left Hand Side”, for the three branches of the coeliac trunk:
- L - Left gastric
- H - common Hepatic
- S - Splenic
It arises at T12, supplies the foregut, and is the shortest of the three midline visceral arteries.
The three midline branches follow a simple sequence: coeliac at T12 (foregut), superior mesenteric at L1 (midgut), inferior mesenteric at L3 (hindgut), with the paired renal arteries between at L1 to L2.
The rich anastomoses around the stomach mean the coeliac trunk can be ligated in trauma or aneurysm surgery with the liver and stomach usually surviving on collateral flow.
Expansion
Arising from the abdominal aorta at T12, the coeliac trunk is short and divides into:
- Left gastric artery - lesser curvature; gives oesophageal branches
- Splenic artery - runs along the upper border of the pancreas; gives short gastric, left gastro-omental and pancreatic branches
- Common hepatic artery - gives the gastroduodenal artery, then continues as the proper hepatic artery, which gives the right gastric and cystic arteries
It supplies the entire foregut, so its territory is the stomach, the duodenum as far as the ampulla, the liver, gallbladder, pancreas and spleen.
The splenic artery is characteristically tortuous, which distinguishes it on imaging. Compression of the trunk by a low median arcuate ligament produces postprandial epigastric pain, and coeliac occlusion is often tolerated because of the rich pancreaticoduodenal anastomosis with the superior mesenteric artery.