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Updated: Oct 23, 2025

The Role of Anatomical Dissection in Defining Colic and Small Bowel Artery Lymphovascular Bundles in the D3 Volume of Small and Large Bowel Mesentery
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Aberrant Left Colic Artery and Its Surgical Implications.

Anett Christiena1, Nagaraj Kapil2, Irfan Ansari3

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|August 19, 2021
PubMed
Summary

A rare aberrant left colic artery (ab LCA) originating from the superior mesenteric artery (SMA) was identified during surgery for transverse colon cancer. This anatomical variation, previously un-reported clinically, highlights potential risks during abdominal surgeries.

Keywords:
aberrant left colic arterycolonic conduitcolonic resectionsmasplanchnic vascular anomaly

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Area of Science:

  • Vascular anatomy
  • Surgical anatomy
  • Gastrointestinal surgery

Background:

  • Arterial anomalies, particularly those of the celiac and superior mesenteric arteries, are documented variations in visceral vasculature.
  • Variations in colonic blood supply are relevant for esophageal replacement conduit surgery and oncological resections.
  • The aberrant left colic artery (ab LCA) is a rare arterial anomaly, previously described anatomically but not in a clinical context.

Observation:

  • A middle-aged female presented with abdominal pain and lower gastrointestinal bleeding, diagnosed with transverse colon malignancy.
  • During an extended right hemicolectomy with complete mesocolic excision and D3 lymphadenectomy, an ab LCA was identified.
  • The ab LCA originated from the superior mesenteric artery (SMA) below the pancreatic border, unusually high and near the middle colic artery origin.

Findings:

  • The aberrant left colic artery (ab LCA) was successfully dissected and preserved during the oncological resection.
  • This case represents the first clinical report of an ab LCA encountered during surgical intervention.
  • The unusual anatomical course of the ab LCA poses a risk of iatrogenic injury.

Implications:

  • Iatrogenic injury to the ab LCA during colonic or pancreatic surgery can lead to increased patient morbidity.
  • Awareness of this rare arterial variation is crucial for surgeons to prevent inadvertent damage.
  • Detailed anatomical knowledge and careful surgical technique are essential when managing patients with potential vascular anomalies.