Anomalous origin and vulnerable course of left colic artery in relation to the pancreas—A case report

Satheesha Badagabettu Nayak,Surekha Devadasa Shetty,Swamy Ravindra Shanthakumar,Srinivasa Rao Sirasanagandla,Ashwini Aithal

doi:10.4236/fmar.2013.14018

Abstract

We report here an anomalous origin and course of left colic artery in relation to pancreas during routine dissection of the abdominal region in a 70-year-old male cadaver in the department of anatomy. The anomalous left colic artery took its origin from the superior mesenteric artery and immediately divided into right and left branches. The right branch passed through the transverse mesocolon to supply the left one third of the transverse colon. The left branch traversed to the left along the inferior border of the body of the pancreas and crossed the left kidney before supplying the left colic flexure of colon and descending colon. This aberrant course of the left branch of the left colic artery can be considered as a “vulnerable” course as it is liable to injury during pancreatic and renal surgeries since the artery is not expected to run along the inferior border of the pancreas. The pancreas, a retroperitoneal organ, is related to major arteries such as abdominal aorta, inferior vena cava, coeliac trunk and its main branches, superior mesenteric vessels, splenic and portal veins. Surgery of the pancreas therefore, not only needs a thorough knowledge of the normal course of branches of these vessels but also demands a good knowledge of possible anomalous vessels arising in this region.

Highlights

The abdominal aorta gives three ventral branches, namely the celiac trunk, the superior mesenteric artery and the inferior mesenteric artery
The celiac trunk supplies the derivatives of the foregut; the superior mesenteric artery supplies the derivatives of the midgut and the inferior mesenteric artery supplies the derivatives of the hindgut
It is closely related to the abdominal aorta, inferior vena cava, coeliac trunk and its branches, superior mesenteric vessels, splenic and portal veins

Summary

INTRODUCTION

The abdominal aorta gives three ventral branches, namely the celiac trunk, the superior mesenteric artery and the inferior mesenteric artery. The left colic artery is the first branch of inferior mesenteric artery. It ascends retroperitoneally and divides into ascending and descending branches. The normal course of the left colic artery is not closely related to the pancreas. It is closely related to the abdominal aorta, inferior vena cava, coeliac trunk and its branches, superior mesenteric vessels, splenic and portal veins. In 1960s, its postoperative morbidity rate was 60% and mortality rate was about 25% [3]. We present a case of the anomalous origin and course of left colic artery and discuss its clinical importance

CASE REPORT

Findings

DISCUSSION