AnatomyAbdomenNerves, vessels and lymphatics of the abdomenCeliac trunk

AnatomyAbdomenNerves, vessels and lymphatics of the abdomenCeliac trunk

Celiac trunk

Author: Shahab Shahid, MBBS • Reviewer: Uruj Zehra, MBBS, MPhil, PhD
Last reviewed: January 29, 2024
Reading time: 10 minutes

The celiac trunk (or coeliac trunk) is a major artery that supplies the foregut of the gastrointestinal tract. It arises from the abdominal aorta at the level of the twelfth thoracic vertebrae. It gives off three major branches, the left gastric, common hepatic and splenic arteries.

The gastrointestinal tract extends from mouth to the rectum, and enables us to gain nutrients from the food we eat. Gut associated lymphoid tissue performs immunological function by eliminating bacteria and intraluminal toxin and protects the intestinal mucosa from invading pathogens. It has various parts that are specialized to absorb certain nutrients and vitamins e.g. vitamin B12 and bile salts are absorbed in the terminal ileum. The bowel develops in three separate sections, namely the foregut, midgut and hindgut supplied by separate nerves, arteries, and veins. This article will describe the celiac trunk (which supplies the foregut), including its branches, and clinical relevance.

Key facts about the celiac trunk
Origin	Abdominal aorta at the level of the 12th thoracic vertebra
Branches	Left gastric, common Hepatic and Splenic arteries Mnemonic: Left Hand Side
Supplies	Foregut of the gastrointestinal tract
Clinical points	Peptic ulcers, splenic artery aneurysms, Pringle's maneuver, celiac artery compression syndrome

Contents

Anatomy of the gastrointestinal tract
Branches of the celiac trunk
Clinical points
Sources

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Anatomy of the gastrointestinal tract

Parts

Celiac trunk (inferior view)

Three major divisions of the gastrointestinal tract are foregut, midgut and hindgut. The foregut extends from the mouth to the major duodenal papilla (where the ampulla of Vater empties into the duodenum). The midgut extends from this point to two thirds of the way along the transverse colon. The hindgut runs from this point to the superior rectum.

Blood supply

The celiac trunk supplies the foregut, superior mesenteric artery supplies the midgut and the inferior mesenteric artery supplies the hindgut. The coeliac artery arises from the abdominal aorta as soon as it passes through the diaphragm at the level of the twelfth thoracic vertebrae. It gives off three major branches i.e. the left gastric, common hepatic and splenic.

Innervation

In the same sense, the sympathetic input to the foregut, midgut and hindgut are supplied by the greater, lesser and least thoracic splanchnic nerves respectively. The parasympathetic input to the foregut and the midgut is supplied by the vagus nerve (cranial nerve X), while it is supplied by the pelvic splanchnic nerves (S2-S4) to the hindgut.

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Branches of the celiac trunk

Left gastric artery

This is the smallest and the first branch that arises from the coeliac trunk and passes into the lesser omentum (which connects the lesser curvature of the stomach to the liver) along the lesser curvature of the stomach to supply its superior portion.

Here it anastomoses with right gastric artery. Some branches of the left gastric artery also supply the inferior part of the oesophagus.

Common hepatic artery

This branch arises from the celiac trunk and runs towards the liver and in order to enter the lesser sac. The common hepatic artery then gives off the gastroduodenal artery and continues as the hepatic artery proper above the first part of the duodenum. At this level, the hepatic artery proper gives off the right gastric artery which runs between the peritoneal layers of the lesser omentum to supply the lesser curvature of the stomach and anastomoses with the left gastric artery. The hepatic artery proper then bifurcates near the porta hepatis divides into the right and left hepatic arteries that enter the liver. These vessels then divide further into lobar arteries.

The common hepatic artery then divides into the hepatic artery proper and the gastroduodenal artery. At the porta hepatis the hepatic artery proper divides into the right and left hepatic arteries and enter the liver. These vessels then divide further into lobar arteries.

The gastroduodenal artery arises posterosuperior to the first part of duodenum, giving off the posterior superior pancreaticoduodenal artery and other small branches (retro-/supraduodenal arteries) before terminating as as the anterior superior pancreaticoduodenal and right gastroomental arteries, the latter of which supplies the greater curvature of the stomach. The anterior and posterior superior pancreaticoduodenal arteries supply the head of the pancreas and the anterior and posterior surfaces of the duodenum; they anastomose with their counterpart branches of the inferior pancreaticoduodenal artery (first branch of the superior mesenteric artery).

Celiac trunk inside a cadaver: The easiest way to locate and isolate the celiac trunk (it is only 2 cm long) during a cadaveric dissection is to follow the common hepatic artery towards the left side of the abdomen. The celiac trunk arises from the anterior surface of the abdominal aorta at the level of the 12th thoracic vertebra.

Splenic artery

This is a tortuous branch that runs towards the hilum of the spleen. On the way it has a number of arteries that supply the neck, body and tail of the pancreas. It also gives off the left gastroomental artery that supplies the greater curvature of the stomach, and anastomoses with the right gastroepiploic artery.

The splenic artery also gives off the short gastric arteries before it reaches the hilum of the spleen. It runs within the gastrosplenic ligament in order to supply the fundus of the stomach as well as the superior part of the greater curvature of the stomach. It anastomoses with the left gastric artery.

Test your knowledge on the arteries of the stomach, liver, and gallbladder with this quiz.

Learn more about abdominal blood vessels with our articles, video tutorials, quizzes, and diagrams.

Mnemonic

There is an easy way to remember the branches of the splenic artery! The mnemonic ' Peter's Spleen Looks Small' stands for:

Pancreatic a.
Splenic a.
Left gastroepiploic a.
Short gastric a.

To summarize and have a clear picture in your mind, take a look at the following diagram illustrating the branches of the celiac trunk!

Branches of the celiac trunk

Mnemonic

Althought the celiac artery only has 3 branches, your memory can still fail you sometimes. Thankfully kenhub is here to help! Just memorise the mnemonic 'Left Hand Side' and it will help you remember the branches:

Left gastric a.
Common Hepatic a.
Splenic a.

Ready for a quick test? Check out our custom tailored quiz on the celiac artery and its branches below

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Clinical points

Peptic ulcers

A peptic ulcer is an erosion in the mucosa of the stomach that commonly results from the presence of H.Pylori bacteria or the overuse of non-steroidal anti-inflammatory medications e.g. aspirin. If it becomes deep enough it may erode into a major vessel (commonly the left gastric artery) resulting in massive blood loss.

Splenic artery aneurysms

These are rare but are the third most common abdominal aneurysm (after aneurysms of the abdominal aorta and iliac arteries). High blood pressure and smoking are risk factors for aneurysm formation and the treatment of choice is percutaneous endovascular treatment, or an open operation if that is not possible. Aortic aneurysms are most commonly infrarenal (below the renal arteries).

Pringle’s maneuver

The liver is a very vascular organ (as it is supplied by the hepatic arteries and the hepatic portal vein that carries the venous blood from the bowels). Hence, in order to reduce blood loss during liver surgery, the portal triad can be clamped. The portal triad consists of the (common) bile duct, the hepatic artery proper and the hepatic portal vein.

Coeliac artery compression syndrome

The median arcuate ligament is a part of the diaphragm, and it forms the crura of the diaphragm on either side of the abdominal aorta as it passes through the diaphragm. The insertion point of this ligament may be too low in some people, leading to compression of the coeliac trunk. This can result in epigastric pain resulting from the ischaemia, weight loss and abdominal bruit. Treatment includes surgical decompression that is usually performed via laparoscopic (keyhole) operation.

Sources

All content published on Kenhub is reviewed by medical and anatomy experts. The information we provide is grounded on academic literature and peer-reviewed research. Kenhub does not provide medical advice. You can learn more about our content creation and review standards by reading our content quality guidelines.

References:

Frank H.Netter MD: Atlas of Human Anatomy, 5th Edition, Elsevier Saunders.
Chummy S.Sinnatamby: Last’s Anatomy Regional and Applied, 12th Edition, Churchill Livingstone Elsevier.
Richard L. Drake, A. Wayne Vogl, Adam. W.M. Mitchell: Gray’s Anatomy for Students, 2nd Edition, Churchill Livingstone Elsevier.
S. Aditya Dr. and D. Donna Dr. et al: Coeliac artery. Radiopaedia.org (accessed 11/01/2016).
J.P McMurrich, D.J.Sobotta: Atlas and textbook of Human Anatomy.

Illustrators:

Celiac trunk (inferior view) - Stephan Winkler
Celiac trunk inside a cadaver - Prof. Carlos Suárez-Quian

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