The pancreaticoduodenal arcade refers to an arterial network that links the blood flow of the celiac artery and superior mesenteric artery via the superior and inferior pancreaticoduodenal arteries.
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Gross anatomy
Origin
The pancreaticoduodenal arcades originate from the superior pancreaticoduodenal artery (branch of the gastroduodenal artery) and the inferior pancreaticoduodenal artery (branch of the superior mesenteric artery) 1,2.
Course
Forming arcades from the anastomosed branches of anterior and posterior branches of the superior and inferior pancreaticoduodenal arteries, the pancreaticoduodenal arcades encircle the head of the pancreas 1.
Supply
head of the pancreas 2
duodenum 2
Variant anatomy
In some cases, the pancreaticoduodenal arcades may pass through the parenchyma of the pancreas 2.
There may be as few as one or as many as four arcades 2.
Clinical importance
The collateral flow produced by the pancreaticoduodenal arcades is a useful redundancy in cases of occlusion 3. It can, however, create problems such as recurrent bleeding following embolization 3,4. This “back door” bleeding following embolization occurs due to collateral flow afforded by the arcade. Therefore, an understanding of the vascular anatomy is important in the planning of embolization 3,4.
In celiac artery stenosis, the arcade undergoes significant dilation to provide collateral flow via the superior mesenteric artery 5. In cases of severe stenosis or complete occlusion, the entire blood supply of the liver may be supplied by the pancreaticoduodenal arcades 6.
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