Gastroduodenal artery !

The gastroduodenal artery runs down behind the first part of the duodenum to feed it and the pancreas; an ulcer there can erode it and bleed heavily.

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What it is

A branch of the common hepatic artery running down behind the first part of the duodenum.

What it does

Supplies the pylorus, the duodenum and the head of the pancreas.

Key facts

Origin: Common hepatic artery; descends behind the first part of the duodenum
Branches: Right gastroepiploic artery; superior pancreaticoduodenal arteries (anterior and posterior); supraduodenal branches
Supplies: First part of duodenum, pancreatic head, greater curvature of stomach; eroded by a posterior duodenal ulcer (major bleeding)

Relations

Course: Leaves the common hepatic artery above the first part of the duodenum and runs down behind it, on the front of the neck and head of the pancreas, to its lower border
In front: Posterior wall of the first part of the duodenum and the pylorus
Behind: Neck of the pancreas and, deeper, the portal vein
Lateral: Common bile duct, to its right, with the posterior superior pancreaticoduodenal artery spiralling around the duct

How to find it

Found at the upper edge of the first part of the duodenum, where the common hepatic artery divides; it then runs down behind the duodenal bulb and in front of the neck of the pancreas. At endoscopy it lies just behind the posterior wall of the bulb, the reason a deep ulcer there bleeds from it.

On imaging

On CT it is a small bright vessel on the front of the pancreas that marks the junction of head and neck. In a bleeding ulcer not controlled at endoscopy, angiography can show contrast leaking from it and allow embolization.

Common problems

A posterior duodenal ulcer can erode into it and cause major bleeding (vomiting blood, black stools).

How it is diagnosed

Ultrasound screening; CT.

Treatment

Monitoring of small aneurysms; repair with a stent-graft through the groin arteries or open surgery for large ones.

Clinical notes

Bleeding posterior duodenal ulcer: when endoscopy fails, the artery is embolized, or the duodenum is opened and the vessel under-run with stitches above, below and medially (the last for its transverse pancreatic branch)
Tied in a pancreatoduodenectomy; its stump can form a pseudoaneurysm and bleed late, especially after a pancreatic leak
Pancreatitis can erode it into a pseudoaneurysm, a cause of sudden bleeding into the gut or into a pseudocyst

Test yourself

Think of the answer, then tap the question to see it.

Where does the gastroduodenal artery arise and run?

From the common hepatic artery; it runs down behind the first part of the duodenum, on the front of the pancreatic neck and head, just left of the common bile duct.

What are the terminal branches of the gastroduodenal artery?

The right gastro-omental (gastroepiploic) and anterior superior pancreaticoduodenal arteries, at the lower border of the first part of the duodenum.

Which ulcer erodes the gastroduodenal artery, and how is the bleeding controlled if endoscopy fails?

A posterior duodenal ulcer; the artery is embolized, or the duodenum is opened and the vessel under-run with stitches above, below and medially.

Why is the gastroduodenal artery an important collateral?

Its pancreaticoduodenal branches join the inferior pancreaticoduodenal arteries from the superior mesenteric artery around the pancreatic head: the main celiac–SMA link.

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Educational information, not medical advice. For any symptom, see a health professional.

Its names

Official Latin (TA2): arteria gastroduodenalis TA2 4215
Official Spanish (DeCS): Arteria gastroduodenal
English (TA2): Gastroduodenal artery

Sources: Terminologia Anatomica (TA2); Anatomy, Abdomen and Pelvis: Celiac Trunk; Anatomy of the Human Body (20th ed.): The Abdominal Aorta (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain.

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Representative model, for educational purposes only.