Aberrant Left Colic Artery and Accessory Right Colic Artery: A Case Report and Surgical Implications.

During a routine dissection of the abdominal region in our department of anatomy's dissection laboratory, we found two variations of the vasculature of the gastrointestinal tract within the greater peritoneal and retroperitoneal compartments: an aberrant left colic artery (LCA) and an accessory right colic artery (RCA). The aberrant LCA originates from a common trunk (CT) that arises from the superior mesenteric artery instead of the inferior mesenteric artery. The CT continues for a short distance and terminates by dividing into a middle colic artery and an accessory RCA. The aberrant LCA and accessory RCA had abnormal courses; therefore, they are vulnerable to injury during surgical procedures of the region. Hence, a thorough knowledge of vascular variations is required to avoid potential complications.

Aberrant Left Colic Artery and Its Surgical Implications.

Arterial anomalies of the viscera are not unusual. Of the arterial anomalies, the celiac and the superior mesenteric anomalies are well studied and reviewed in the literature. These variations are due to changes occurring during the development of vessels. Also, the variations in the colonic blood supply have been detailed in the context of conduit surgery in esophageal replacement and oncological resections. Of these, the rarer anomaly is the aberrant left colic artery (ab LCA). Previously described in various anatomic descriptions; it has never been reported in a clinical situation. A middle-aged female presented with abdominal pain and lower gastrointestinal (GI) bleed. On further evaluation, she was diagnosed to have transverse colon malignancy. She underwent extended right hemicolectomy with complete mesocolic excision and D3 lymphadenectomy as classically described. During the dissection, she was found to have an LCA arising from the superior mesenteric artery (SMA) just below the inferior border of the pancreas two centimeters higher to the origin of the middle colic artery. This artery was carefully dissected and preserved. Injury of the ab LCA is possible given the unusual course of the artery. Implications of iatrogenic injury in colonic and pancreatic surgeries may result in additional morbidity which is discussed in detail.

Variant Arterial Supply of the Descending Colon by the Coeliac Trunk: A Case Report.

Background and Objectives: Knowledge of arterial variations of the intestines is of great importance in visceral surgery and interventional radiology. Materials and Methods: An unusual variation in the blood supply of the descending colon was observed in a Caucasian female body donor. Results: In this case, the left colic artery that regularly derives from the inferior mesenteric artery supplying the descending colon was instead a branch of the common hepatic artery. Conclusions: Here, we describe the very rare case of an aberrant left colic artery arising from the common hepatic artery in a dissection study.