Background
The posterior gastric artery (PGA) is frequently encountered during posterior dissection of the stomach in gastrointestinal procedures. Literature suggests significant variability in the presence and origin of the PGA along the splenic artery, with meta-analysis reporting a higher prevalence on intraoperative assessment compared to CT scans. (1) This study aims to determine the proportion of patients with a visible PGA during arterial phase CT scans and its origins from either the proximal or distal half of the splenic artery.
Methods
A total of 145 patients aged 18 to 100 who underwent abdominal CT scans in the arterial phase between December 2023 and February 2024 were included. After tutorials with a senior upper gastrointestinal surgeon, residents and registrars were tasked with reviewing the scans. Ethical approval was obtained from the ERM ethics committee. Patients with poor-quality images, duplicate CT scans and PGA views obstructed by anatomical structures were excluded.
Results
Among the 145 patients, 30 (20.7%) had a visible PGA, while 100 (69.0%) did not. Fifteen patients were excluded due to poor image quality, obscured views, or duplicate scans. Of those with a visible PGA, 16 (53.3%) had the artery originating from the proximal splenic artery, and 14 (46.7%) from the distal aspect.
Conclusion
The PGA is visible in a minority of patients on arterial phase CT scans, with origins distributed similarly between proximal and distal splenic artery. These findings underscore the importance of recognising PGA variability in preoperative planning and surgical procedures as it is often unreported by radiologists.