case_images: PMC10911783_01
case_images: 3D-CT angiography findings. A typical MCA originating from the SMA was absent. An anomalous MCA originating from the SA running below the pancreas body (yellow arrow) was visualized. RCA, right colic artery; ICA, ileocecal artery.
case_images: crg-2024-0018-0001-536672_F01.jpg
case_images: PMC10911783_01_crg-2024-0018-0001-536672_F01.jpg
case_images: F1
case_images: Enhanced CT showed no regional or distant metastasis, so the colon cancer was diagnosed as cT2N0M0 cStage I. 3D-CT angiography showed the absence of a typical MCA originating from the SMA and the presence of an anomalous MCA originating from the celiac artery and the SA (Fig. 1).
case_images: Laparoscopic findings during lymph node dissection. a The lymph nodes around the SMA were dissected via the caudal view, and the absence of a typical MCA was confirmed. b An anomalous MCA originating from the SA was identified below the pancreas body. c Laparoscopic view after completion of total mesenteric excision. Stump of the anomalous MCA (yellow arrow) originating from the SA was observed just below the pancreas body (gray arrow).
case_images: crg-2024-0018-0001-536672_F02.jpg
case_images: PMC10911783_01_crg-2024-0018-0001-536672_F02.jpg
case_images: F2
case_images: After entire splenic flexure mobilization, the lymph nodes around the SMA were dissected via the caudal view, and the absence of a typical MCA was confirmed (Fig. 2a). The anomalous MCA originating from the SA was then identified just below the pancreatic body (Fig. 2b), where it was successfully clipped and dissected. These procedures completed a total mesenteric excision of the tumor area (Fig. 2c).