Esophageal branches of left gastric artery

Esophageal branches of the left gastric artery are small arterial branches that arise from the left gastric artery as it ascends along the lesser curvature of the stomach toward the gastroesophageal junction. These branches supply the abdominal segment of the esophagus and contribute to the vascular network of the distal esophagus.

Anatomical Overview

The left gastric artery is typically the smallest branch of the celiac trunk. After originating from the celiac trunk, it courses superiorly and to the left within the gastropancreatic fold of the lesser omentum, reaching the cardiac region of the stomach. Before turning inferiorly along the lesser curvature, the left gastric artery gives off several ascending esophageal branches that travel through the esophageal hiatus of the diaphragm to supply the lower esophagus.

Key Features

• Origin: These branches arise from the ascending portion of the left gastric artery near the gastroesophageal junction.

• Distribution: They supply the anterior and posterior walls of the abdominal (and lower thoracic) esophagus, anastomosing with esophageal branches of the thoracic aorta and the inferior phrenic arteries.

• Clinical significance:

  • They form part of the submucosal arterial plexus of the distal esophagus, which is relevant in the context of esophageal varices in portal hypertension, as the submucosal veins in this region serve as portosystemic collaterals.

  • Knowledge of these branches is important during surgical procedures such as Nissen fundoplication, esophagectomy, and gastrectomy, where inadvertent injury may compromise esophageal blood supply.

  • They are also relevant in transarterial embolization for lower esophageal or gastric bleeding.

Anastomotic Connections

The esophageal branches of the left gastric artery participate in a rich anastomotic network with:

• Esophageal branches of the thoracic aorta (proper esophageal arteries)

• Branches of the inferior phrenic arteries

• Branches of the short gastric arteries (in some anatomical variants)