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Splenic Artery – Anatomy and Clinical Relevance

The splenic artery is the largest branch of the celiac trunk and supplies the spleen, pancreatic tail, and parts of the stomach with oxygenated blood.

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Things worth knowing about "Splenic Artery"

The splenic artery is the largest branch of the celiac trunk and supplies the spleen, pancreatic tail, and parts of the stomach with oxygenated blood.

Definition and Anatomy

The splenic artery (Latin: Arteria splenica, formerly Arteria lienalis) is a major abdominal artery that arises from the celiac trunk, which itself branches directly from the abdominal aorta. The splenic artery follows a characteristically tortuous (winding) course along the superior border of the pancreas before reaching the spleen. It is one of the longest visceral arteries in the human body, ranging from approximately 8 to 32 cm in length.

Course and Branches

The splenic artery is divided into three anatomical segments:

Pancreatic segment: The artery runs posterior to the stomach and along the upper border of the pancreas, giving off several pancreatic branches (rami pancreatici) that supply the body and tail of the pancreas.
Pre-splenic segment: Just before reaching the spleen, the artery gives rise to the left gastroomental artery (supplying the greater curvature of the stomach) and the short gastric arteries, which supply the fundus of the stomach.
Splenic (hilar) segment: At the splenic hilum, the artery divides into multiple terminal branches that enter the spleen and supply its parenchyma in a segmental pattern.

Vascular Territory

The splenic artery is responsible for the blood supply to the following structures:

Spleen: The primary target organ; the spleen plays a central role in immune defense and blood filtration.
Pancreatic body and tail: Via the pancreatic branches, a large portion of the pancreas receives its arterial supply from the splenic artery.
Gastric fundus and greater curvature: Via the short gastric arteries and the left gastroomental artery.

Clinical Significance

Splenic Artery Aneurysm

A splenic artery aneurysm is the most common visceral artery aneurysm, accounting for approximately 60% of all cases. Risk factors include pregnancy, portal hypertension, atherosclerosis, and fibromuscular dysplasia. Small aneurysms are often asymptomatic and discovered incidentally on imaging. However, rupture is a life-threatening emergency presenting with acute left upper quadrant pain and hemodynamic instability. Treatment options include endovascular embolization or open surgical repair, depending on size and clinical context.

Splenic Infarction

Occlusion or high-grade stenosis of the splenic artery or its branches can result in splenic infarction. Common causes include cardioembolic events (e.g., atrial fibrillation), sickle cell disease, vasculitis, or iatrogenic injury. The hallmark symptom is left upper quadrant pain, which may radiate to the left shoulder.

Risk During Pancreatic Surgery

Due to the close anatomical relationship between the splenic artery and the pancreas, surgical procedures such as distal pancreatectomy carry an increased risk of inadvertent vascular injury. Unintended damage may cause acute hemorrhage or postoperative splenic ischemia.

Diagnostic Imaging

The splenic artery is routinely assessed using CT angiography, MR angiography, or Doppler ultrasonography. These modalities are essential for diagnosing aneurysms, stenoses, thromboses, and vascular malformations.

Embryology

The splenic artery develops embryologically from the ventral splanchnic vascular system and is closely linked to the formation of the celiac trunk. Anatomical variants, such as a direct origin from the aorta or a common hepatosplenic trunk, are rare but clinically relevant in surgical and interventional planning.

References

Standring, S. (Ed.): Gray's Anatomy – The Anatomical Basis of Clinical Practice. 42nd edition, Elsevier, 2021.
Pasha, S.F. et al.: Splanchnic artery aneurysms. In: Mayo Clinic Proceedings, 82(4):472–479, 2007.
Selo-Ojeme, D.O. et al.: Ruptured splenic artery aneurysm in pregnancy. In: Archives of Gynecology and Obstetrics, 2003.

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