Case report of variant origin and course of the middle colic artery

The middle colic artery is of key importance regarding the blood supply of the digestive tract. Visceral surgery, in particular, relies on detailed knowledge of the anatomical course of arteries in this region. Several variants of the bowel’s arterial supply have been reported, and we contribute the description of yet another variant. We observed an unusual origin and course of the MCA in a body donor from the voluntary donation program of the Institute of Anatomy, Otto-von-Guericke University Magdeburg. The donor had died from coronary heart disease and cardiac insufficiency, and the body was fixed by arterial perfusion with an ethanol-formaldehyde solution. Dissection was performed during regular undergraduate anatomy courses at the institute. We describe a variant middle colic artery (aMCA) that, instead of arising from the SMA, branches directly from the celiac trunk alongside the usual vessels. The aMCA descends behind the pancreas, gives off an inferior pancreatic artery, and then divides into two branches: one connecting to the regular MCA from the SMA and the other to the LCA from the IMA. While the IMA showed a normal branching pattern, the SMA lacked a right colic artery; no additional anatomical or pathological abnormalities were observed. Although parts of the herein described variation have already been published - such as an aMCA arising from the celiac trunk or variations in connectivity of the MCA with the RCA and LCA - the combination of variations reported here is, to our best knowledge, not yet documented. • An accessory middle colic artery (aMCA) arose directly from the celiac trunk. • The aMCA ran behind pancreas, supplied pancreatic artery, joined middle/left colic. • The SMA had no right colic artery; the IMA showed a normal branching pattern.