Coeliac trunk
Truncus coeliacus
Also known as: celiac trunk, celiac axis, coeliac axis
The coeliac trunk is the first unpaired branch from the front of the abdominal aorta, at T12. It is a short trunk, about 1–2 cm long, that divides into the left gastric, splenic and common hepatic arteries. These supply the foregut, the liver, the gallbladder, part of the pancreas and the spleen.
Overview
The coeliac trunk arises just below the aortic hiatus. The median arcuate ligament of the diaphragm lies above it. The trunk is surrounded by the coeliac plexus, the coeliac ganglia and the coeliac lymph nodes. It lies behind the lesser sac and above the body of the pancreas and the splenic vein. It typically divides into three branches at once (the coeliac tripod).
Its territory is the foregut: the abdominal oesophagus, the stomach and the duodenum as far as the major duodenal papilla. It also supplies the liver, gallbladder, pancreas and spleen. The spleen is mesodermal and is not a foregut derivative, but it shares this supply.
The pancreaticoduodenal arcades link the coeliac and superior mesenteric territories. The superior pancreaticoduodenal arteries come from the gastroduodenal artery (coeliac), and the inferior pancreaticoduodenal arteries from the SMA. This connection can keep the liver supplied when the coeliac trunk is narrowed.
- Location
Front of the abdominal aorta at T12, behind the lesser sac and above the pancreas.
Anatomy
- Branches
The left gastric artery, the splenic artery and the common hepatic artery. Sometimes it also gives the inferior phrenic arteries.
Function
- Supplies the foregut derivatives (distal oesophagus to the 2nd part of the duodenum), the liver, the gallbladder, much of the pancreas and the spleen.
Clinical significance
Chronic mesenteric ischaemia
Atherosclerotic narrowing of two or more of the three gut arteries causes "intestinal angina": pain after eating, fear of food and weight loss.
Median arcuate ligament syndrome
In median arcuate ligament (Dunbar) syndrome, the ligament compresses the coeliac trunk. Patients have pain after eating, weight loss and an epigastric bruit that changes with breathing.
Coeliac plexus block
In pancreatic cancer, pain can be relieved by injecting local anaesthetic and alcohol around the coeliac plexus, next to the trunk. Foregut pain is felt in the epigastrium.
Mnemonics
Branches
"Left Hand Side": Left gastric, (common) Hepatic, Splenic.
Test yourself
At which vertebral level does the coeliac trunk usually arise from the aorta?
- T10
- T12
- L2
- L3
Answer: T12
The coeliac trunk arises at T12, just below the aortic hiatus. The SMA arises at L1, the renal arteries at L1–L2, the gonadal arteries at L2 and the IMA at L3, and the aorta bifurcates at L4.
Compiled from standard anatomy and physiology references — see the Cardiovascular System sources. For education only; not medical advice.