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Left gastric artery

The left gastric artery (LGA) is the smallest branch of the celiac trunk, arising from its superior aspect just after its origin from the abdominal aorta. It ascends toward the esophageal hiatus, then courses along the lesser curvature of the stomach between the two layers of the lesser omentum. Along its course, the LGA gives off esophageal branches to the lower esophagus before descending to supply the stomach.

The artery runs from left to right along the lesser curvature, forming important anastomoses with the right gastric artery (branch of the common hepatic artery). This connection is essential for maintaining blood flow in case of vascular compromise. The LGA plays a major role in the arterial supply of the stomach and abdominal esophagus, making it clinically significant in surgery, endoscopy, and interventional radiology.

Synonyms

  • LGA

  • Arteria gastrica sinistra

  • Coronary artery of the stomach (historic term)

Function

  • Provides oxygenated blood to the lesser curvature of the stomach

  • Supplies the lower esophagus via esophageal branches

  • Contributes to gastric mucosal perfusion important for digestion

  • Forms vital anastomoses with the right gastric artery, ensuring collateral circulation

Branches

  • Esophageal branches → supply the abdominal esophagus

  • Gastric branches → supply the lesser curvature of the stomach and gastric mucosa

MRI Appearance

T1-weighted images:

  • Lumen shows signal void (black) due to arterial flow

  • Vessel wall is hypointense; surrounded by hyperintense fat in the lesser omentum, aiding localization

T2-weighted images:

  • Lumen appears as a signal void

  • Perivascular edema, inflammation, or tumor encasement may appear hyperintense

STIR (Short Tau Inversion Recovery):

  • Fat suppression improves visualization of the artery against surrounding omental fat

  • Pathology (e.g., inflammation, edema, tumor invasion) appears bright hyperintense near the vessel

T1 Post-Contrast (Gadolinium-enhanced):

  • LGA enhances brightly and homogeneously

  • Useful for mapping course, caliber, stenosis, aneurysm, or tumor encasement

  • Enhances identification of its esophageal and gastric branches

MRA (Magnetic Resonance Angiography):

  • Contrast-enhanced MRA provides high-resolution depiction of the LGA and its branching pattern

  • Excellent for preoperative planning (e.g., gastric surgery, bariatric surgery, esophagectomy)

  • Identifies stenosis, aneurysm, dissection, or collateral circulation with 3D reconstruction capability

CT Appearance

Non-contrast CT:

  • Appears as a tubular soft tissue density structure near the lesser curvature and esophageal hiatus

  • Calcifications, if present, appear as hyperdense foci

CT Angiography (CTA):

  • Clearly demonstrates the origin from the celiac trunk, course along the lesser curvature, and branches

  • Identifies stenosis, aneurysm, pseudoaneurysm, dissection, or tumor invasion

  • Excellent for preoperative vascular mapping in gastric cancer, bariatric procedures, or upper GI bleeding interventions

  • 3D CTA reconstructions provide detailed gastric vascular anatomy

CT images

Left gastric artery anatomy CT axial image -img-00000-00000

CT images

Left gastric artery ct axial

MRI images

Left gastric artery anatomy MRI axial image -img-00000-00000