Absence of the celiac trunk: definition, classification, MDCT angiographic findings and their probable embryological mechanisms

Abstract Background: The aim of this study was to identify the types and prevalence of absence of the celiac trunk by using multidetector computed tomography (MDCT) angiography, and analyze their probable embryological mechanisms. Methods: A retrospective study was carried out on 2,500 abdominal MDCT angiography images. The absence of the celiac trunk was defined as that the celiac trunk is not exist, more specifically, there is not such an arterial trunk containing at least two major branches of the celiac trunk. Various types of the absence of the celiac trunk were investigated. Results: Of the 2,500 patients, 19 (0.76%) patients were identified as an absence of the celiac trunk. According to its definition and classification, the absence of the celiac trunk could be divided into five types: type I (LGA + CHA + SA + SMA), type II (HM trunk + LGA + SA), type III (SM trunk + LGA + CHA), type IV (GM trunk + CHA + SA), and type V (other type); and these types were observed in 5 patients (0.20%), 9 patients (0.36%), 3 patients (0.12%), 0 patients (0.00%) and 2 (0.08%) patients, respectively. There were more examples of the types I and II than of the types III–V (P = 0.004). Conclusions: We systematically classified the absence of the celiac trunk based on its MDCT angiography findings. Abnormal interruptions and persistence of the longitudinal anastomosis, and regression of vascular root and emergence of replaced artery could all be the embryological mechanisms of various types of the absence of the celiac trunk.