1. Dr. Ahmed Fathalla Ibrahim
ARTERIAL SUPPLY OF FOREGUT
Dr. Ahmed Fathalla Ibrahim

3. The coeliac trunk
Origin: It is one of the single branches of the abdominal aorta, at the level of upper border of L1.
Relations: It lies behind the posterior wall of the lesser sac. It is surrounded by the coeliac plexus of nerves & by the coeliac lymph nodes. It is related to the coeliac ganglia & to the crura of diaphragm, one on each side.

4. BRANCHES OF COELIAC ARTERY
LEFT GASTRIC ARTERY
COMMON HEPATIC ARTERY
SPLENIC ARTERY

5. THE LEFT GASTRIC ARTERY:
It is the smallest branch of the coeliac trunk.
Course: It runs upwards, behind the posterior
wall of the lesser sac to reach the esophagus
then turns forwards & downwards to enter the lesser omentum where it runs along the lesser curvature of stomach & anastomoses with the right gastric artery.
Branches:
Oesophageal branches.
Gastric branches.

6. THE COMMON HEPATIC ARTERY
Course: It runs to the right up to the first part of duodenum then curves upwards & ascends in the free margin of lesser omentum (to the left of common bile duct & anterior to the portal vein). The artery (now called the hepatic artery proper) reaches the portal hepatis & divides into 2 terminal branches.

7. THE COMMON HEPATIC ARTERY
Branches:
Gastroduodenal artery: It descends behind the first part of duodenum (to the left of the common bile duct & anterior to the portal vein) & divides into: right gastro-epiploic artery that enters the greater omentum & runs along the greater curvature of stomach & anastomosing with left gastro-epiploic artery & superior pancreatico-duodenal artery that runs between head of pancreas & duodenum & anastomosing with inferior pancreatico-duodenal artery.

8. THE COMMON HEPATIC ARTERY
Branches:
Right gastric artery: It enters the lesser omentum along the lesser curvature of stomach, anastomosing with the left gastric artery.
Supraduodenal artery: It supplies the first part of duodenum.
Cystic artery: It arises from the right terminal hepatic branch. It supplies the gall bladder & biliary ducts.
Left & right terminal hepatic branches: They supply left & right lobes of liver.

9. THE COMMON HEPATIC ARTERY
APPLIED ANATOMY: Collateral circulation to the liver in case of occlusion of hepatic artery:
If the common hepatic artery is occluded: efficient collateral circulation through anastomoses between gastro-epiploic, pancreaticoduodenal & gastric arteries.
If the hepatic artery is occluded: no efficient collateral circulation, blood only reaches the liver through the inferior phrenic arteries.

10. THE SPLENIC ARTERY It the largest branch of coeliac artery.
Course: It runs to the left following a tortuous course. It lies behind the posterior wall of the lesser sac separating it from the stomach. It passes along the upper border of body of pancreas, in front of left kidney. It enters the lieno-renal ligament to reach the hilum of the spleen.

11. THE SPLENIC ARTERY Branches:
Left gastro-epiploic artery: It enters the greater omentum, along the greater curvature of stomach & anastomoses with the right gastro-epiploic artery.
Short gastric arteries: They pass through the gastro-splenic ligament & supplies fundus of stomach.
Pancreatic branches: They supply neck, body & tail of pancreas.
Terminal splenic branches.