The superior horizontal pancreatic artery of Popova: a review and an anatomoradiological study of an important morphological variant of the pancreatica magna artery

Purpose: the superior horizontal pancreatic artery was described in 1910 and after a few years it was forgot by most investigators. This research is aimed to revive the description of this artery, describing course, pattern of branching and frequency. Methods: more than 1000 of angiographies including studies of the superior mesenteric artery, celiac trunk and its branches, were selected from the angiographic archives of the ex-institutes of Radiology of Siena, Rome (University of Sacro Cuore), and Perugia and the arterial anatomy of the pancreas was studied. Results: a pancreatic branch of the splenic artery running along the superior border of the pancreatic body and tail was observed in 25.93% of cases. This branch matched the description of the superior horizontal pancreatic artery and, when existing, replaced the pancreatica magna artery. For this reason, we considered the superior horizontal pancreatic artery as a variant of the pancreatica magna artery. Variable in calibre and importance, in most cases the superior horizontal pancreatic artery gave off descending branches that anastomosed with the inferior pancreatic artery. Conclusions: a superior horizontal pancreatic artery could be visualized more easily by selective angiography of the splenic artery. When coupled with the inferior pancreatic artery, the presence of the superior horizontal pancreatic artery outlined a longitudinally arranged pattern of blood supply of the distal pancreas that should be known. In particular circumstances, extended resections of the gland cutting both longitudinal arteries might jeopardize the surviving of the pancreas remnant.