Right or subtotal colectomy either open or laparoscopic may be a
challenging operation owing to technical difficulties. One of these, is
to identify a safe and adequate dissection plane, ligating and
dissecting lymph nodes around middle colic vessels. The purpose of this
study was to depict a rare anatomic variation of middle colic vein (MCV)
draining to splenic vein. We report the case of a 55-year-old male
patient, who was subjected to a right hemicolectomy for an
adenocarcinoma in the ascending colon. During dissecting the transverse
mesocolon from the greater omentum, for complete mesocolic excision
(CME), we encountered that the MCV drained in the splenic vein. With
respect of this rare anatomic variability, CME was completed without
hemorrhage. Our aim is to depict that deep knowledge of MCV anatomy and
its variations is of paramount importance to achieve CME and to avoid
dangerous or massive bleeding
