The coeliac trunk is the artery of the foregut, supplying the stomach, liver, spleen, pancreas, and duodenum through its three immediate branches. It is notable for its extremely short course and immediate trifurcation, making it a surgical landmark in upper abdominal operations. Median arcuate ligament syndrome (coeliac artery compression syndrome) from compression by the median arcuate ligament of the diaphragm is an increasingly recognised cause of postprandial pain in young patients.
| Origin | Anterior abdominal aorta at T12, immediately below the aortic hiatus |
|---|---|
| Course | Very short trunk (1-2 cm) dividing immediately into three branches to supply the foregut organs |
| Branches |
The coeliac axis and its branches must be identified during radical gastrectomy, distal pancreatectomy, pancreaticoduodenectomy (Whipple procedure) and liver transplantation. Its gastroduodenal branch runs directly behind the first part of the duodenum, which is why a posterior duodenal ulcer can erode into it and cause major haemorrhage. True coeliac trunk aneurysms are uncommon compared with splenic and hepatic artery aneurysms but carry a significant rupture risk and are usually treated once they reach about 2 cm. CT angiography defines the anatomy before pancreatic and liver surgery, as variants such as a replaced right hepatic artery from the SMA are common.
Coeliac trunk compression by the diaphragmatic ligament producing postprandial pain and weight loss in young adults, treated by surgical or laparoscopic ligament division.
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