Total colonic supply via the inferior mesenteric artery.
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PURPOSE: To present a unique case of vascular supply to the gastrointestinal organs as anatomical variants have variable clinical implications and must be recognized to avoid adverse outcomes. METHODS: Describe the embryological origin of vascular supply of gastrointestinal organs and present a few variants described in the literature. RESULTS: On angiogram, patient was found to have total colonic supply via the inferior mesenteric artery. This is a rare anatomical variant which altered management in this child with massive lower gastrointestinal bleed due to sacral neuroblastoma metastasis and mucormycosis colitis. CONCLUSION: Vascular anatomic variants have clinical implications that can alter management.