Unusual Collateral Pathways in Triple Vessel Occlusion-Nature’s Way of Survival in Mesenteric Ischemia

This case report describes a unique case of chronic pancreatitis who presented to us with pancreatic cancer. The patient also had a rare presentation of three-vessel occlusion involving origins of the celiac trunk, superior mesenteric artery, and inferior mesenteric artery. However multiple unusual and rare collaterals were seen taking over the abdominal circulation with no ischemic changes in concerned organs. Such a phenomenon is rare and only one case with triple vessel occlusion has been described in the literature. However triple vessel involvement in the setting of pancreatic disease has not been reported to our best knowledge. Information about these rare collaterals is important for the management of hepatic tumors, pancreaticobiliary surgery, and liver transplantation.