Importancia clínica del Arco de Bühler: Implicaciones en la planeación de procedimientos abdominales.
Palabras clave:
Arco de Bühler, tronco celíaco, arteria mesentérica superior, radiología intervencionista, cirugía abdominal.Resumen
El arco de Bühler es una anastomosis embriológica que se encuentra a nivel del tronco celíaco y la arteria mesentérica superior. Es considerado una variante anatómica de baja frecuencia, cuya prevalencia se estima entre el 1-7% y el 1,9%. Sin embargo, su significación radica en el abordaje de procedimientos médico-quirúrgicos y radiológicos, especialmente de predominio abdominal. El artículo proporciona una revisión de la literatura en la que se destaca la importancia anatómica de esta variante, así como sus implicaciones clínicas, quirúrgicas y radiológicas, con el fin de generar un manejo oportuno y adecuado de patologías relacionadas con sus hallazgos.
Descargas
Referencias
1. Dubel GJ, Ahn SH, Saeed MA. Interventional management of arc of buhler aneurysm. Semin Intervent Radiol [Internet]. 2007; 24(1):76-81. DOI: 10.1055/s-2007-971193
2. Kowalczyk KA, Pękala J, Kawzowicz M, Pękala PA, Tomaszewski KA. The meta-analysis and systematic review of prevalence and clinical anatomy of the arc of Buhler. Sci Rep. 2023; 13(1):9183. DOI: 10.1038/s41598-023-36316-9
3. Yan G, Li Y, He S, Li H, McClure MA, Li Q, et al. Prevalence and clinical implications of the rare arc of Bühler using computed tomography angiography and digital subtraction angiography: a systematic review and meta-analysis. Front Med (Lausanne). 2024; 11:1522292. DOI: 10.3389/fmed.2024.1522292
4. Biswas S, Gogna S. Arc of Buhler pseudoaneurysm causing fatal retroperitoneal hemorrhage; A rare case report and discussion of relevant literature. Bull Emerg Trauma. 2019; 7(2):183-6. Disponible en: https://beat.sums.ac.ir/article_45351_37b5b50b30677761e4a0dd224f5c4254.pdf
5. Kageyama Y, Kokudo T, Amikura K, Miyazaki Y, Takahashi A, Sakamoto H. The arc of Buhler: special considerations when performing pancreaticoduodenectomy. Surg Case Rep. 2016; 2(1):21. DOI: 10.1186/s40792-016-0149-2 https://surgicalcasereports.springeropen.com/articles/10.1186/s40792-016-0149-2
6. Nikolaos S, Vasilios P, Niki L, Argyriou EO, Theodoros K, Mihalis A. Arc of Buhler: A lifesaving anatomic variation. A case report. J Vasc Bras. 2020; 19. https://pmc.ncbi.nlm.nih.gov/articles/PMC8218005/pdf/jvb-19-e20200045.pdf
7. Rathod S, Kolus R, Kim B, Gurnani S, Kim A, Kim E, et al. A case of abnormally dilated and tortuous arc of Buhler and pancreaticoduodenal arteries in the absence of celiac trunk stenosis. Surg Radiol Anat. 2022; 44(10):1343-7. DOI: 10.1007/s00276-022-03018-2
8. Jayia P, Hosney S, Subramanian A, Onnie C. Arc of Buhler aneurysm: a rare cause of obstructive jaundice. Vasc Endovascular Surg. 2011; 45(1):92. DOI: 10.1177/1538574410379652
9. Michalinos A, Schizas D, Ntourakis D, Filippou D, Troupis T. Arc of Bühler: the surgical significance of a rare anatomical variation. Surg Radiol Anat. 2019; 41(5):575-581. DOI: 10.1007/s00276-018-2168-0 https://pubmed.ncbi.nlm.nih.gov/30552487/
10. Schumacher, L., Albrecht, H.C. & Gretschel, S. A significant vascular variant in oncologic pancreaticoduodenectomy: the arc of Buhler. Surg Case Rep. 2022; 8,37. DOI: 10.1186/s40792-022-01387-9
11. Matsumoto AH, Angle JF, Spinosa DJ, Hagspiel KD, Ayers C, Larsen W, et al. Interventional management of arc of Buhler aneurysm. J Vasc Interv Radiol. 2001; 12(8):968-71.
12. Radiopaedia.org. Arc of Bühler. . [citado 6 de abril de 2025]. Disponible en: https://radiopaedia.org/articles/arc-of-buhler-1 Radiopaedia+1Radiopaedia+1
13. Katsuki T, Komatsu T, Takano K, Kato N, Kondo S, Saito T, et al. Arc of Buhler: a lifesaving anatomic variation. A case report. J Vasc Bras. 2021; 20:e20200180. SpringerLink+2PMC+2SciELO Brasil+2
14. Myers JL, Losseff SV, Gomes MN. Surgical repair of an aneurysm of the Arc of Buhler in a patient with von Recklinghausen’s disease. J Vasc Surg. 1998; 28(4):724-7.
15. Yoshida R, Fukutomi T, Tanaka K, Matsumoto T, Kinoshita Y, Matsumoto H, et al. Rupture of aneurysm in the arc of Bühler caused by median arcuate ligament syndrome. Vasc Health Risk Manag. 2019; 15:19-23.
16. Karaosmanoglu AD, Karcaaltincaba M. Three-dimensional imaging of arc of Buhler. J Radiol Case Rep. 2010; 4(7):1-4.
17. Ong CP, Lee V, Ho S, Tan BS. Coil embolization of arc of Buhler aneurysm rupture. Case Rep Vasc Med. 2020; 2020:8855946.
18. Saad WEA, Davies MG, Sahler L, et al. Arc of Buhler: Incidence and Diameter in Asymptomatic Individuals. Vascular and Endovascular Surgery. 2005; 39(4):347-349. DOI:10.1177/153857440503900407
19. Kim JH, Lee YS, Lee JB, Kim KW, Kim SJ. Transcatheter coil embolization of an arc of Buhler aneurysm. Korean J Radiol. 2008;9(Suppl):S77-81. KJR Online+1Wiley Online Library+1
20. Perrin M, Rolland Y, Verhoye JP. An arc of Bühler variant. Morphologie. 2021; 105(350):37-40. ScienceDirect
21. Moll FL, Powell JT, Fraedrich G, Verzini F, Haulon S, Waltham M, et al. Management of abdominal aortic aneurysms clinical practice guidelines of the European society for vascular surgery. Eur J Vasc Endovasc Surg. 2011; 41 Suppl 1:S1-58. DOI: 10.1016/j.ejvs.2010.09.011
22. Chaikof EL, Brewster DC, Dalman RL, Makaroun MS, Illig KA, Sicard GA, et al. SVS practice guidelines for the care of patients with an abdominal aortic aneurysm: executive summary. J Vasc Surg. 2009;50(4):880-96. DOI: 10.1016/j.jvs.2009.07.001
23. Quaretti P, Corti R, D’Agostino AM, Bozzani A, Moramarco LP, Cionfoli N. Covered stent assisted coil embolization of large Buhler aneurysm in setting of chronic celiac trunk occlusion. CVIR Endovasc. 2024; 7(1):9. DOI: 10.1186/s42155-023-00416-4
24. McNulty JG, Hickey N, Khosa F, O’Brien P, O’Callaghan JP. Surgical and radiological significance of variants of Bühler’s anastomotic artery: a report of three cases. Surg Radiol Anat. 2001; 23(4):277-80. DOI: 10.1007/s00276-001-0277-6
25. Abe K, Iijima M, Tominaga K, Masuyama S, Izawa N, Majima Y, et al. Retroperitoneal hematoma: Rupture of aneurysm in the arc of Bühler caused by median arcuate ligament syndrome. Clin Med Insights Case Rep. 2019; 12:1179547619828716. DOI: 10.1177/1179547619828716
26. Belli A-M, Markose G, Morgan R. The role of interventional radiology in the management of abdominal visceral artery aneurysms. Cardiovasc Radiol. 2012; 35(2):234-43. DOI: 10.1007/s00270-011-0201-3
27. Chaer RA, Abularrage CJ, Coleman DM, Eslami MH, Kashyap VS, Rockman C, et al. The Society for Vascular Surgery clinical practice guidelines on the management of visceral aneurysms. J Vasc Surg. 2020; 72(1S):3S-39S. DOI: 10.1016/j.jvs.2020.01.039
28. Sharbidre KG, Aziz MU, Mohd Z. Review of abdominal vascular variations: Imaging and clinical implications. Radiographics [Internet]. 2022; 42(1):E27-8. DOI: 10.1148/rg.210093
29. McCracken E, Turley R, Cox M, Suhocki P, Blazer DG 3rd. Leveraging aberrant vasculature in celiac artery stenosis: The Arc of Buhler in pancreaticoduodenectomy. J Pancreat Cancer. 2018; 4(1):4-6. DOI: 10.1089/pancan.2017.0020
30. Manta BA, Rusu MC, Jianu AM, Ilie AC. Hexafurcated coeliac trunks, trifurcated common hepatic artery, and a new variant of the arc of Bühler. Folia Morphol (Warsz). 2022;81(2):365-71. Disponible en: https://journals.viamedica.pl/folia_morphologica/article/view/FM.a2021.0025/55195
31. Zaheer A. Mesenteric artery collateral pathways. In: Zimmerman SL, Fishman EK, editors. Pearls and Pitfalls in Cardiovascular Imaging. Cambridge: Cambridge University Press; 2015. p. 258-9.
Descargas
Publicado
Número
Sección
Licencia
Derechos de autor 2026 Laura Mena-Ocampo, Carolina Molina, Nicolas Mosquera, Diana Marcela Osorio-Roa
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
La Revista Salutem Scientia Spiritus usa la licencia Creative Commons de Atribución – No comercial – Sin derivar: Los textos de la revista son posibles de ser descargados en versión PDF siempre que sea reconocida la autoría y el texto no tenga modificaciones de ningún tipo.
