Aberrant splenic artery rising from the superior mesenteric artery: a rare but important anatomical variation

• DOI: 10.1007/s00276-018-02177-5
• Publication Date: 2019-01-03T14:18:07Z
• Authors: Emanuele Felli; Taiga Wakabayashi; Pietro Mascagni; Zineb Cherkaoui; Vanina Faucher; Patrick Pessaux
• Keywords: Aged, 80 and over; 0301 basic medicine; Superior/*anatomy and histology; Anatomic Variation; Anatomic variations; X-Ray Computed; 3. Good health; Mesenteric ischemia; 03 medical and health sciences; Splenic Artery/*anatomy and histology; Mesenteric Artery, Superior; Superior mesenteric artery; 80 and over; Splenic artery; Humans; Female; Tomography, X-Ray Computed; Mesenteric Artery; Tomography; Splenic Artery; [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology; Aged

Aberrant splenic artery originating from the superior mesenteric artery (SMA) is extremely rare and recognition of this anomaly is important in the pre-operative planning of complex surgery such as pancreatic surgery, liver transplantation and vascular surgery. We present the case of an 80-year-old female diagnosed as septic shock due to mesenteric ischemia and obstructive pyelonephritis. Her splenic artery was originating from the SMA and the anomaly was readily appreciated on the pre-operative CT images. An explorative laparotomy associating extensive small bowel resection with endarterectomy of the proximal part of the SMA was performed. During intra-operative SMA control, we confirmed the aberrant splenic artery arising from SMA, and successfully avoid any arterial injury on the splenic artery with isolation and separated proximal and distal clamping. The anatomical vascular variation should be recognized in the pre-operative work-up of a determined surgical procedure to avoid potential intra-operative arterial injuries.