The anatomy of the fundic branches of the stomach: preliminary results

The fundic branches of the stomach can be defined as a group of vessels that can arise either directly or indirectly from the following source arteries: the left inferior phrenic artery, the accessory left hepatic artery, the left gastric artery, the left middle suprarenal artery, the main trunk of the splenic artery, the posterior gastric artery, the superior polar artery, the gastrosplenic artery, the left gastroepiploic artery and the splenic artery with its inferior and superior terminal branches. It is worth mentioning that the fundic branches of the left gastroepiploic artery and the superior and inferior terminal branches of the splenic artery, like other vessels arising from these three source arteries and supplying the stomach, are defined as short gastric arteries. The anatomy of these fundic branches, particularly relevant to some surgical procedures, is not sufficiently described, and the current literature suffers from lack of publications on this particular topic. We therefore decided to explore in detail the arterial vascularisation of the gastric fundus. The research was carried out on material consisting of 15 human stomach specimens. The anatomical analysis comprised the following: the number of occurrences of fundic branches in each of the source arteries defined above, the distance between the origins of the source artery and its arising fundic branch, the way in which the fundic branches arose, the length, diameter at point of origin and morphology of the fundic braches, as well as the exact point of perforation of each fundic branch on the fundus. The highest incidence of the direct-branching pattern of fundic branches was in the left middle suprarenal artery, the gastrosplenic artery and the left gastrosplenic artery. The accessory left hepatic artery, the left gastric artery and the main trunk of the splenic artery were the most frequent site of the indirectly arising pattern of fundic branch. The highest median value of fundic branch length was 63.05 mm, found in the accessory left hepatic artery group. The largest median diameter value of the vessel was encountered among those originating in the left middle suprarenal artery and reached 2.17 mm. The posterolateral quadrant of the fundus received the largest number of fundic branches, amounting to 46.5% of all the fundic branches studied. (Folia Morphol 2008; 67: 120–125