Abstract
We report a case of a 30-year-old female with bilateral lower extremity weakness where computed tomography angiography (CTA) demonstrated a rare variant of abdominal aortic visceral branching pattern with a common trunk arising from the aorta subsequently dividing into celiac axis, superior mesenteric artery, and bilateral renal arteries. Additionally, significant stenosis was seen involving abdominal aorta distal to this common trunk suggesting midaortic syndrome. A hypertrophied arc of Riolan was also noted. This is an exceedingly rare anatomical variant discovered on CTA reflecting pivotal role of imaging in identifying such variant anatomy which can attribute to patients' symptoms and guide further management. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12055-025-01983-y.