Surgical and radiological significance of variants of Buhler's anastomoticartery: a report of three cases

Arterial anastomoses between the celiac trunk (CT) and superior mesenteric artery (SMA) include three variants. 1) The main anastomosis is the gastrod uodenal artery (GDA), which is an important branch of the common hepatic ar tery and anastomoses with branches of the inferior pancreatic duodenal arte ry, a branch of the SMA. 2) The dorsal pancreatic artery (DPA) is usually a branch of the splenic artery, which anastomoses with the anterior and post erior pancreaticoduodenal arcades via a right transverse branch of the DPA (Kick's arcade). 3) A less well known and rarely reported arterial anastomo sis between the CT and SMA described by Buhler (1904). Three patients in wh om variants of this anastomosis were present on retrospective analysis of t hree hundred consecutive combined CT and SMA arteriograms are reported. The embryological basis of its development, the surgical and radiological sign ificance of the anastomotic artery are discussed.