Answer to Grumpy Young Men
Correct answer is C, the gastroduodenal artery. The arterial pattern from the celiac trunk presented in the image is the most commonly found one. The common hepatic artery will divide into the hepatic artery proper and the gastroduodenal artery, the latter which runs posterior to the first part of the duodenum. It is at this portion of the duodenum that peptic ulcers are most commonly located. If the ulcers progress, as in the clinical scenario presented, the posterior wall of the first part of the duodenum can erode away and the stomach acids that spill into the peritoneal cavity will encounter the wall of the gastroduodenal artery and lead to its erosion and massive intestinal bleed. Patients can die if not treated immediately.
= Common hepatic a.
= Hepatic artery proper
= Gastroduodenal a.
= Right gastric a.
= Splenic a.
Answer to this question is based on material presented in lectures 7of the Abdomen Lecture Series.
