In a fifty-three-year old Japanese woman, a 3-cm-diameter saccular, calci fied aneurysm was detected beneath the pancreas during surgery for cholelithi asis. She was then referred to the authors' institution, where an aneurysm was detected on the medial wall of an anomalous celiac axis, that is, the hepato splenic trunk as a branch of an anomalous hepatosplenomesenteric trunk. This vascular anomaly was identified as type III in Adachi's classification of the structural variation of the celiac axis. The aneurysm was resected, and revascu larization of the hepatic and splenic arteries was successful following insertion of an autogenous vein graft.
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