PMC6388328_01
PMC6388328_02
Middle colic artery arising from the gastroduodenal artery. (a) Intraoperative photograph. One vessel loop is around the neck of the pancreas, and the second vessel loop is encircling the origin of the gastroduodenal artery. The anterior and posterior superior pancreaticoduodenal arteries and smaller unnamed branches off the gastroduodenal artery have been ligated. The common bile duct has already been transected. (b) Illustration of the middle colic artery arising from the gastroduodenal artery as seen during the pancreaticoduodenectomy. RHA: right hepatic artery; LHA: left hepatic artery; LGA: left gastric artery; SMA: superior mesenteric artery; SA: splenic artery; RGEA: right gastroepiploic artery; PSPDA: posterior superior pancreaticoduodenal artery; MCA: middle colic artery; JA: jejunal arteries.
CRIS2019-1986084.001.jpg
PMC6388328_02_CRIS2019-1986084.001.jpg
fig1
This indicated that the vessel was an anomalous middle colic artery that originated from the gastroduodenal artery (Figures 1 and 2).
Middle colic artery arising from the gastroduodenal artery. Intraoperative photographs. One vessel loop is around the neck of the pancreas, and the second vessel loop is encircling the origin of the gastroduodenal artery. The anterior and posterior superior pancreaticoduodenal arteries and smaller unnamed branches off the gastroduodenal artery have been ligated. The common bile duct has already been transected. (a) The aberrant middle colic artery can be seen running into the transverse colon mesentery (transverse colon seen in the bottom left corner). (b) The aberrant middle colic is seen crossing on top of the pancreatic neck. The common bile duct is transected, and the bull dog clamp is on the proximal common bile duct.
CRIS2019-1986084.002.jpg
PMC6388328_02_CRIS2019-1986084.002.jpg
fig2
This indicated that the vessel was an anomalous middle colic artery that originated from the gastroduodenal artery (Figures 1 and 2).