# Replacing middle colic artery arising from the splenic artery—an arterial variety in a patient undergoing total pancreatoduodenectomy

## TL;DR

A rare arterial variation was found in a patient undergoing pancreas surgery, involving a middle colic artery from the splenic artery.

## Contribution

This paper reports a previously undocumented arterial branching pattern involving the middle colic artery.

## Key findings

- A replacing middle colic artery was found arising from the splenic artery.
- The arterial variation was associated with a type III hepatic artery according to Michel’s classification.
- This combination of arterial variations has not been previously described in the literature.

## Abstract

Knowledge of variations in arterial vascular supply is crucial in HPB and general surgery. Although the arterial configuration of the coeliac trunk and the superior mesenteric artery had been investigated, there are still arterial branching patterns to be described. We herein present the case of an 84-year-old male patient who underwent total pancreatectomy due to a not specified pancreas head tumor with a replacing right hepatic artery according to Michel’s classification III and a replacing middle colic artery arising from the splenic artery and running on the ventral side of the pancreas. To the best of our knowledge, this arterial branching pattern has never been described so far. In this case, two arterial variations had been presented with a type III arterial supply according to Michel’s classification, and a replacing middle colic artery arising from the SA.