Introduction
The gastroduodenal artery is the terminal branch of the common hepatic artery. The gastroduodenal artery supplies the pyloric part of the stomach, the head of the pancreas, and the proximal part of the duodenum. It is located in the abdomen's epigastric (upper central region) and courses through the duodenum. The gastroduodenal artery is very close to the duodenal bulb's proximal wall, the duodenum's first part. Hence, an injury to this artery is one of the most common causes of upper gastrointestinal tract bleeding. It is divided into two branches: the gastroepiploic branch and the superior pancreaticoduodenal arteries.
What Is the Anatomy of Gastroduodenal Artery?
The common hepatic artery is a branch of the celiac trunk. The first major branch of the abdominal aorta is the celiac artery. The common hepatic artery divides into two branches: the proper hepatic artery and the gastroduodenal artery. The two terminal branches of the gastroduodenal artery are the right gastroepiploic artery and the superior pancreaticoduodenal artery.
The gastroduodenal artery has a unique anatomical location and connects the foregut and the midgut. It is seen posterosuperior to the upper border of the superior part of the duodenum. It passes inferiorly behind the duodenal bulb to the left of the common bile duct. There, it gives rise to the supraduodenal artery. It goes down behind the duodenum and divides into two branches at the lower border of the duodenum.
The position of the gastroduodenal artery is an important factor in planning and doing a hepatopancreaticobiliary (HPB) surgery. It lies close to the duodenal bulb, the common bile duct, and the head of the pancreas. Hence, the location makes it susceptible to injuries, resulting in bleeding during and after the surgeries. There are a large number of blood vessels and vascular innervations depending on the gastroduodenal artery.
What Are the Branches of the Gastroduodenal Artery?
The gastroduodenal artery gives rise to two branches when it reaches the upper border of the pancreas. The two branches include;
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Right Gastroepiploic Artery: This originates between the duodenum's superior part and the pancreas. It then goes left to the greater omentum at the head of the pancreas. The parietal and visceral peritoneum of the abdominal cavity are prevented from sticking to each other by the greater omentum. The peritoneum is the membrane that covers the abdominal organs. From there, it goes on along the greater curvature of the stomach. It goes along the greater omentum and gives rise to gastric and omental branches. It joins with the left gastroepiploic branch of the splenic artery approximately in the middle of the greater curvature of the stomach. The stomach has two curvatures: the greater curvature and the lesser curvature. The greater curvature is four to five times larger than the lesser curvature. The right gastro-epiploic artery is also known as the right gastro-omental artery or the arteria gastroepiploic extra. The blood supply of the right gastroepiploic artery is to the anterior and the posterior antrum and the lower part of the stomach. It also supplies the inferior branches to the right greater omentum.
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Superior Pancreaticoduodenal Artery: It is a gastroduodenal artery branch providing blood supply to the duodenum and the pancreas. This is a paired artery consisting of anterior and posterior branches. The anterior branch goes inferiorly in the groove between the duodenum and the pancreas. It then joins with the anterior branch of the inferior pancreaticoduodenal artery and provides blood supply to the head of the pancreas. The superior pancreaticoduodenal artery's posterior branch arises at the duodenum's upper border. It joins with the posterior division of the inferior pancreaticoduodenal artery and supplies superior and descending parts of the duodenum.
What Are the Functions of the Gastroduodenal Artery?
The main function of the gastroduodenal artery is to supply blood to the pylorus, which is the distal part of the stomach and the proximal region of the duodenum. This artery also supplies to the pancreatic head.
What Is the Clinical Significance of This Artery?
The gastroduodenal artery can have a significant role in gastrointestinal bleeding. This can also arise as a result of the complications of peptic ulcer disease. Since it lies very close to the posteromedial wall of the duodenum, deep ulcers that are penetrating or tumors of the duodenum can cause bleeding. This is mainly because of the abundant arterial network in the region, which ensures high blood flow in the gastroduodenal artery. The anatomical position of the artery is very important in planning and performing a hepatopancreaticobiliary (HPB) surgery. The artery lies close to the duodenal bulb, the common bile duct, and the head of the pancreas. Therefore, this location makes it more susceptible to injuries, which may result in bleeding during and after the surgeries.
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Gastroepiploic Artery Aneurysms: An aneurysm is an abnormal bulge or ballooning in the artery. This usually occurs in the weak area of the artery. Aneurysm in a visceral artery is very rare. A visceral artery aneurysm is an aneurysm found in the splenic, hepatic, renal, or mesenteric arteries. Gastroepoic artery aneurysms constitute 3.5 percent of visceral artery aneurysms. Atherosclerotic (build-up of fats, cholesterol, and other substances in the blood vessel) disease is the most common cause. An aneurysm is usually asymptomatic and is usually diagnosed only after it ruptures.
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Esophagectomy: The left and right gastroepiploic arteries provide blood supply to the stomach. Most clinicians prefer to preserve the right gastroepiploic artery or blood supply while other blood vessels are joined to mobilize the stomach.
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Graft for Heart Surgery: The right gastroepiploic artery is an appropriate and dependable graft for coronary bypass surgery. This is mainly because it is less likely to undergo atherosclerotic changes. In some ways, it reflects the function of the internal thoracic artery.
Conclusion
The gastroduodenal artery arises from the common hepatic artery. It gives rise to two branches and supplies the stomach, pancreas, and the upper part of the duodenum. It has a unique anatomical position and is important in planning out liver, pancreas, and bile duct surgeries. It can be a cause of gastrointestinal bleeding, and thorough knowledge of its anatomy is required for the management of the bleeding.
