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Arc of Bühler: the surgical significance of a rare anatomical variation

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PurposeThe 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.… Click to show full abstract

PurposeThe 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.MethodsA 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”.ResultsOnly 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.ConclusionsVarious radiologic and surgical procedures such as embolization or pancreaticoduodenectomy are potentially affected by its existence.

Keywords: hler; artery; variation; arc hler; pancreaticoduodenal arcades

Journal Title: Surgical and Radiologic Anatomy
Year Published: 2018

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