Adamantios Michalinos1, Dimitrios Schizas2, Dimitrios Ntourakis3, Dimitrios Filippou1, Theodore Troupis4. 1. Department of Anatomy and Surgical Anatomy, School of Medicine, National and Kapodistrian University of Athens, Tetrapoleos 18, 75 Mikras Asias Str, 11527, Athens, Greece. 2. 1st Department of Surgery, Faculty of Medicine, National and Kapodistrian University of Athens, Tetrapoleos 18, 11527, Athens, Greece. 3. Department of Surgery, European University of Cyprus, Diogenis Str 6, 2404, Nicosia, Cyprus. 4. Department of Anatomy and Surgical Anatomy, School of Medicine, National and Kapodistrian University of Athens, Tetrapoleos 18, 75 Mikras Asias Str, 11527, Athens, Greece. troupistheodore@gmail.com.
Abstract
PURPOSE: The arc of Bühler, an anastomotic vessel between celiac artery and superior mesenteric artery, is a rare anatomic variation. Various radiologic and surgical procedures can be affected by its existence. We aim to review all available information and identify possible clinical implications. METHODS: A systematic review was conducted in accordance to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. The following terms were utilized in various combinations: "Bühler", "arc of Bühler", "visceral aneurysm", "pancreaticoduodenal arcades". RESULTS: Only 53 cases have been described until today in the literature. The arc of Bühler enhances collateral circulation between celiac artery and superior mesenteric artery alongside with pancreaticoduodenal arcades and dorsal pancreatic artery. Computerized tomography and angiography are the main studies used for its detection and evaluation. Aneurysms of Bühler's arc have been rarely described and seem to share common pathophysiological mechanisms with aneurysms of the pancreaticoduodenal arcades. CONCLUSIONS: Various radiologic and surgical procedures such as embolization or pancreaticoduodenectomy are potentially affected by its existence.
PURPOSE: The arc of Bühler, an anastomotic vessel between celiac artery and superior mesenteric artery, is a rare anatomic variation. Various radiologic and surgical procedures can be affected by its existence. We aim to review all available information and identify possible clinical implications. METHODS: A systematic review was conducted in accordance to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. The following terms were utilized in various combinations: "Bühler", "arc of Bühler", "visceral aneurysm", "pancreaticoduodenal arcades". RESULTS: Only 53 cases have been described until today in the literature. The arc of Bühler enhances collateral circulation between celiac artery and superior mesenteric artery alongside with pancreaticoduodenal arcades and dorsal pancreatic artery. Computerized tomography and angiography are the main studies used for its detection and evaluation. Aneurysms of Bühler's arc have been rarely described and seem to share common pathophysiological mechanisms with aneurysms of the pancreaticoduodenal arcades. CONCLUSIONS: Various radiologic and surgical procedures such as embolization or pancreaticoduodenectomy are potentially affected by its existence.
Entities:
Keywords:
Angiography; Buhler’s arc; Celiac artery; Superior mesenteric artery