A Case of MCA Arising from ICA: a Case Report

Overview

Journal Surg Case Rep

Specialty General Surgery

Date 2024 Apr 15

PMID 38619647

Authors

Kai Goyo

Kei Ishimaru

Taichi Miyaji

Masumi Takamoto

Noriaki Kashu

Katsuya Watanabe

Kenji Takagi

Kyosuke Habu

Yusuke Ogi

Hironori Matsumoto

Satoshi Kikuchi

Hiroki Sugishita

Satoshi Akita

Motohira Yoshida

Shigehiro Koga

Taro Oshikiri

Affiliations

Soon will be listed here.

Abstract

Background: Complete mesocolic excision (CME) and central vascular detachment are very important procedures in surgery for colorectal cancer. Preoperative and intraoperative assessments of the anatomy of major colorectal vessels are necessary to avoid massive bleeding, especially in endoscopic surgery. A case with a rare anomaly in which the middle colic artery (MCA) and ileocolic artery (ICA) had a common trunk is reported.

Case Presentation: The patient was a 73-year-old woman diagnosed with ascending colon cancer on colonoscopy. Preoperative abdominal contrast-enhanced computed tomography confirmed that the MCA and ICA had a common trunk. She underwent laparoscopic ileocecal resection for the ascending colon cancer with D3 lymph node dissection. Intraoperative indocyanine green fluorescence imaging was conducted. After confirming vessel bifurcation, the ICA was dissected at the distal end of the MCA bifurcation. The patient has been followed as an outpatient, with no signs of recurrence as of 2 years postoperatively.

Conclusion: A case of an ascending colon cancer with a unique vascular bifurcation pattern was presented. Preoperative and intraoperative evaluations of the major colorectal vessels are very important for preventing perioperative and postoperative complications.

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