PURPOSE: To evaluate the diagnostic efficacy of gastric air filling during DSA-hepatic arteriography of the left lobe in overcoming the pitfalls caused by accessory left gastric artery and left hepatic artery from left gastric artery. MATERIALS AND METHODS: In a prospective study, standard hepatic arteriogram and hepatic arteriogram after ingestion of an effervescent agent were performed in 22 patients with anatomic variation of the celiac axis. The anatomic variations were accessory left gastric artery in 15 patients and left hepatic arteryfrom left gastric artery in seven. RESULTS: Hepatic arteriogram after ingestion of an effervescent agent was excellent in differentiating nodular stomach staining from hepatic tumor staining in the left hepatic lobe in patients with accessory left gastric artery, and for evaluation of the left hepatic lobe when this was obscured by stomach staining. CONCLUSION: Hepatic arteriogram after ingestion of an effervescent agent is a simple and safe method for overcoming angiographic pitfalls due to anatomic variation.