The clinical and operative impact of the hexafurcation of the celiac trunk- Report of an extremely rare case

The celiac trunk is a main splanchnic artery that supplies the intra-abdominal organs of the upper gastrointestinal system. Anatomic vari-ations of the celiac trunk are encountered in 10% of the population, but can pose challenges to many surgical and interventional procedures. We present here a case of hexafurcation of the celiac trunk discovered preoperatively after image staging for gastric cancer. The branches of the celiac trunk were: left and right inferior phrenic artery, arc of Buhler along with the com-mon pattern of common hepatic, left gastric and splenic artery. The highlight of the case is the rarity of this specific pattern, which is seen in less than 1% of the population, and also the pres-ence of an anastomotic path, the arc of Bahler, as a branch of the celiac trunk. It is evident that the variations of the celiac trunk play a major role in operations of the upper abdomen, radiological interventional procedures and other uncommon cases. Thus, the surgeon must be aware of these variations and their frequency to avoid compli-cations. Also, any physician should report any variation discovered, accidentally or not, to help the literature to be updated.