La población estudiada fue de 61 enfermos. Descripción de anomalías arteriales hepáticas tras acceso inicial a AMS. Realizamos reconstrucción tridimensional, MIP, enmascarada, de todos los enfermos para identificación de anomalías arteriales. Estudio de informes realizados tras adquisición de imágenes mediante TCMC. Enfermos y métodoĮstudio restrospectivo de variables clínicas, anatomopatológicas y quirúrgicas de enfermos con indicación de duodenopancreatectomía en nuestro Servicio desde 2008 hasta abril de 2010. ObjetivosĪnalizar anomalías celiaco-mesentéricas de la arteria hepática ante una duodenopancreatectomía, mediante información de tomografía computarizada multicorte (TCMD), en régimen no protocolizado, Protocolizado y con reconstrucción multidimensional, proyección de intensidad máxima (MIP), Tras acceso quirúrgico inicial a AMS.

Estas anomalías adquieren importancia dado que su lesión inadvertida ocasionaría severo compromiso vascular y/o hemorragias perioperatorias. El acceso inicial retroperitoneal de la arteria mesentérica superior (AMS) evitará una intervención poco útil si existe invasión de arteria mesentérica superior, e identificará las variantes anatómicas con origen en arteria mesentérica superior. En determinadas ocasiones no son informadas y solo se descubren durante la intervención quirúrgica. Rutinariamente son identificadas en el preoperatorio mediante tomografía computarizada (TC).

La identificación pre o intraoperatoria de estas anomalías anatómicas, evitará morbilidad adicional a la realización de una duodenopancreatectomía. On being able to identify arterial anomalies with a mixture of preoperative radiological and methodological criteria, with three-dimensional reconstruction, MIP, and initially performing a dissection of the superior mesenteric artery could avoid duodenopancreatectomies that may not benefit the patient and compromise bleeding.Įl sistema hepático arterial presenta variaciones anatómicas en hasta un 45%. Vascular anomalies, right hepatic artery (RHA) (SMA) substitute (subst), 5 (8%) RHA (SMA) accessory (acc), 4 (7%) left hepatic artery (LHA) (left gastric artery) (LGA) acc 3 (5%) common hepatic artery (CHA) (SMA) subst 3 (5%) RHA (SMA) acc+LHA (LGA) acc 2 (3%) CHA (aorta) subst, 1 (2%) RHA+RGA+2 LHA (celiac trunk), 1 (2%) and CHA (SMA)+LHA (LGA) acc. The mean age was 65☑1 years, with 33 (54%) males and 28 (46%) females. ResultsĪ total of 61 patients were included in the study.

A description is given of hepatic artery anomalies after initial access to the SMA. A blind, three-dimensional, MIP reconstruction was performed on all the patients to identify arterial anomalies.

A study was performed on the reports made after image acquisition by MDCT. Patients and methodsĪ retrospective study of the clinical, histopathological and surgical variables was conducted on patients with an indication for duodenopancreatectomy in our Department from 2008 until April 2010. To analyze celiac–mesenteric anomalies of the hepatic artery before duodenopancreatectomy using the information from multidetector computed tomography (MDCT) using a non-standardized method, a standardized method with multidimensional reconstruction, and maximum intensity projection (MIP), after initial surgical access to the SMA. These anomalies acquire importance in that their unnoticed injury could lead to severe vascular compromise and/or perioperative bleeding. The initial retroperitoneal access by the superior mesenteric artery (SMA) will avoid a fairly useless intervention if there is superior mesenteric artery invasion, and will identify the anatomical variations originating in the superior mesenteric artery.

They are routinely identified before surgery using CT imaging, but on certain occasions they are not reported and are only discovered during the surgical operation. Identifying these anatomical anomalies before or during surgery would prevent additional morbidity in performing a duodenopancreatectomy. Up to 45% anatomical variations are found in hepatic arterial system.

Cubo torres lesion