![]() Very few studies have surfaced on the aberrant left colic artery (ab LCA). They have become instrumental in planning interventional radiological and surgical procedures. Celiac, superior mesenteric artery (SMA), and inferior mesenteric artery (IMA) are the three major arterial trunks that supply the foregut, midgut, and hindgut respectively. In the past anatomical studies contributed to the knowledge of their aberrations but with time, high-resolution imaging including contrast-enhanced CT has contributed to the knowledge of arterial anomalies. Normal mesenteric circulation relies on three major arterial trunks which are persistent intersegmental arteries that fail to regress. Implications of iatrogenic injury in colonic and pancreatic surgeries may result in additional morbidity which is discussed in detail. Injury of the ab LCA is possible given the unusual course of the artery. This artery was carefully dissected and preserved. 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. She underwent extended right hemicolectomy with complete mesocolic excision and D3 lymphadenectomy as classically described. On further evaluation, she was diagnosed to have transverse colon malignancy. A middle-aged female presented with abdominal pain and lower gastrointestinal (GI) bleed. Previously described in various anatomic descriptions it has never been reported in a clinical situation. Of these, the rarer anomaly is the aberrant left colic artery (ab LCA). Also, the variations in the colonic blood supply have been detailed in the context of conduit surgery in esophageal replacement and oncological resections. These variations are due to changes occurring during the development of vessels. Of the arterial anomalies, the celiac and the superior mesenteric anomalies are well studied and reviewed in the literature. Arterial anomalies of the viscera are not unusual.
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