Coeliac trunk

At a glance

English

Coeliac trunk

Latin (TA2)

Truncus coeiiacus

System

Artery

Region

Trunk

Side

Single, on the midline

About the coeliac trunk

The coeliac trunk, or coeliac artery, is the first of the three unpaired arteries that leave the front of the abdominal aorta; the two mesenteric arteries, superior then inferior, follow lower down. It is very short, only about a centimetre or so long, and arises almost at a right angle from the aorta as it passes between the crura of the diaphragm, at about the level of the twelfth thoracic or first lumbar vertebra.

It lies behind the lesser sac of the peritoneum, just above the upper border of the pancreas and the splenic vein, with the coeliac plexus and ganglia of autonomic nerves wrapped around it. Almost at once it splits into three branches. The left gastric artery runs up to the oesophageal opening and down the lesser curvature of the stomach. The splenic artery, the largest, winds to the left along the top of the pancreas to the spleen, giving branches to the pancreas, the greater curvature and the fundus. The common hepatic artery heads right to the duodenum and divides into the proper hepatic and gastroduodenal arteries. Sometimes the inferior phrenic arteries arise from the trunk too.

Together these branches supply the organs that develop from the embryonic foregut: the lower oesophagus, the stomach, the first part and upper half of the duodenum, the liver and gallbladder, the upper pancreas and the spleen. Links with the superior mesenteric artery through the pancreaticoduodenal arcades are real but limited. There is no coeliac vein; the blood it delivers returns through the splenic vein and other tributaries of the portal vein to the liver.

A tight median arcuate ligament of the diaphragm can press on the trunk, especially when breathing out, and may cause pain after meals and weight loss. The trunk can also be narrowed by atherosclerosis or develop an aneurysm. Its origin is a landmark for surgeons and radiologists, and the surrounding coeliac plexus can be blocked with local anaesthetic or other agents to relieve severe upper abdominal pain.

Course and supply

Arises from

Arises from the front of the abdominal aorta just below the aortic hiatus of the diaphragm, at about T12 to L1.

Ends in

Divides almost immediately into the left gastric, splenic and common hepatic arteries; sometimes also gives the inferior phrenic arteries.

Supplies

Supplies the foregut organs: the abdominal oesophagus, stomach, upper duodenum, liver and gallbladder, upper pancreas and spleen.