Rare Splenic Vein Variation in Gastric Cancer Surgery: A Clinic-Radiological Vignette

Knowledge of peripancreatic vascular anatomy is critical in performing pancreatic, splenic, and gastric surgery. The splenic vein (SV), a major vein draining the spleen, follows a predictable course. SV variations, which are encountered uncommonly, can pose a surgical challenge particularly in cases involving malignancies such as gastric cancer, potentially increasing the risk of injury and complications. This image vignette documents a uncommon anatomical variant of SV encountered during total gastrectomy with D3 lymphadenectomy, where it lies at the superior border of pancreas and the SA crosses it and moves cranially in the proximal course and then again crosses caudally in the distal course, emphasizing the need for awareness of such anomalies as well as evaluation of imaging and intraoperative vigilance to prevent complications.