Complex anatomic variation in the brachial region

Authors describe a case of a complex anatomic variation discovered during dissection of the humeral region. On the right side, brachial artery followed a superficial course. Musculocutaneous nerve did not pierce coracobrachialis muscle but instead passed below the muscle before continuing in the forearm. On the left side, a communication between musculocutaneous and median nerve was dissected. Those variations are analytically presented with a brief review on their anatomic and clinical implications. Considerations on their embryological origin are attempted

Tetrafurcation of the subscapular artery. Anatomical and clinical implications

Anatomic variations of axillary artery branches are commonly encountered during radiological investigation and surgical operations. Their existence can confuse interpretation of radiological results and lead to undesired complications during surgery. In this report authors describe a rare case of a subscapular arterial trunk that gave origin to thoracodorsal, circumflex scapular, posterior humeral circumflex, and lateral thoracic artery. Such a variation might cause undesired sequelae during trauma management and a variety of common flap harvesting operations including latissimus dorsi, scapular and parascapular flaps. Furthermore it presents embryological interest as it gives insight to embryologic development of axillary area

Corona Mortis: Surgical Anatomy, Physiology and Clinical Significance

Corona mortis (CM) is classically defined as the arterial anastomosis between the obturator artery and the inferior epigastric artery that crosses the posterior aspect of the superior ramus of the symphysis pubis. Its clinical impact is considered great, as it lies within the surgical field of numerous specialties (general surgeons, orthopedists, gynecologists, urologists). Our systematic study of the literature revealed a diversity in the incidence of the Corona Mortis between cadaveric and patient studies. The new technological advances and especially the CT angiography, applied on the retropubic region vessels, have given the chance to obtain more precise depictions and thus estimations on the real incidence of corona mortis. This review intends to extract for the first time the corona mortisrsquo incidence from the major CT angiographic studies in bibliography and compare it with the incidence of CM in the major cadaveric studies. Special attention was given to the question whether this anastomosis is that important as its name implies (mortis) in the clinical setting or not

Μελέτη της δομής και των δεματίων της λευκής ουσίας του προσφηνοειδούς λοβίου: Η σχέση τους στις προσπελάσεις του τριγώνου της πλάγιας κοιλίας

Η ανατομία του ανθρώπινου προσφηνοειδούς λοβίου παρουσιάζει αρκετές παραλλαγές και παραμένει μία από τις λιγότερο χαρτογραφημένες περιοχές του ανθρώπινου εγκεφάλου. Αν και έχει αναφερθεί επανειλημμένα η λειτουργική συνδεσιμότητα του προσφηνοειδούς λοβίου καθώς και η σημασία της, το υποκείμενο κύκλωμα των δεματίων της λευκής ουσίας δεν έχει χαρακτηριστεί ακόμα. Η κατανόηση της υποκείμενης δομικής συνδεσιμότητας αυτών των δικτύων της λευκής ουσίας έχει μεγάλη σημασία για τον ακριβή χαρακτηρισμό των δεματίων, την αποσαφήνιση της λειτουργίας τους και την σχέση τους σε νευροχειρουργικές προσπελάσεις. Ο σκοπός αυτής της διατριβής ήταν η μελέτη της φλοιώδης επιφανειακής ανατομίας και των δεματίων της περιοχής του προσφεινοειδούς λοβίου σε ανατομικά παρασκευάσματα. Χαρτογραφώντας την επιφανειακή ανατομία του προσφηνοειδούς λοβίου και χρησιμοποιώντας την τεχνική διατομής λευκής ουσίας, αναδεικνύουμε τις παραλλαγές της υποβρεγμάτιας αύλακας και της βρεγματοϊνιακής σχισμής καθώς και την ανατομία και συνδεσιμότητα του Sledge Runner Fasciculus (SRF), ραχιαίου τμήματος του άνω επιμήκους δεματίου (SLF-1), του μέσου επιμήκους δεματίου (Mdlf), της κάτω μετωπιαία-ινιακής δεσμίδας, έξω κάψας και του πέμπτου τμήματος του προσαγωγείου (CB-V). Βρήκαμε ότι η επιφανειακή ανατομία του Precuneus εμφανίζει πολλές παραλλαγές. Επίσης καταγράψαμε ότι το MdLF-I συνδέει τον πόλο του κροταφικού λοβού και την άνω κροταφική έλικα με το προσφηνοειδές λοβίο, το SRF να μην συμμετάσχει στη συνδεσιμότητα του προσφηνοειδούς λοβίου αλλά να συνδέει τις φλοιώδεις περιοχές του πρόσθιου σφηνοειδούς λοβίου, του ισθμού του προσαγωγείου και του οπίσθιου τμήματος της παραϊοππόκαμπιας έλικας; το SLF- 1 να συνδέει το προσφηνοειδές λοβίο με περιοχές της έσω επιφάνειας του μετωπιαίου λοβού; το IFOF να συνδέει τον προσφηνοειδές λοβίο με τον μετωπιαίο λοβό και το CB-V να συνδέει το προσφηνοειδές λοβίο με τον έσω κροταφικό λοβό και την ατρακτοειδή έλικα.The anatomy of the human precuneus exhibits significant variability and has remained one of the less accurately mapped areas of the human brain. Although the functional connectivity of the precuneus and its significance have been repeatedly reported, the underlying structural circuit has not been characterized. Understanding the underlying structural connectivity of these networks is critical for refining their circuitry, clarifying their function and implementing safe neurosurgical approaches. The aim of this dissertation was to investigate the surface anatomy and fiber tracts of the precuneal region in cadaveric specimens. By mapping the sulcal anatomy of the precuneus and employing the fiber microdissection technique, we demonstrate the variations of the Subparietal sulcus (SpS) and the parietooccipital sulcus (POS) and the anatomy and connectivity of the Sledge Runner Fasciculus (SRF), dorsal component of the superior longitudinal fasciculus (SLF- 1), middle longitudinal fasciculus (Mdlf), inferior fronto-occipital fasciculus (IFOF), claustrocortical fibers and fifth component of the cingulum bundle (CB-V). We found the Precuneus surface anatomy to be considerably variable. We also found The MdLF-I, connecting the dorsolateral Temporal Pole and STG to the precuneus; SRF not to participate in the connectivity of the precuneus but connecting the cortical areas of the anterior cuneus, anterior lingula, isthmus of the cingulum and posterior parahippocampal gyrus; SLF- 1 connecting the precuneus with areas of the medial frontal lobe ; the IFOF connecting the precuneus with the frontal lobe; claustrocortical fibers connecting the precuneus with the claustrum and The CB-V connecting the precuneus with the regions of the temporal lobe

Bilateral lingual–facial trunk: anatomic and clinical implications

Common origin of lingual and facial artery is a relatively frequent anatomic varia­tion. Instead, bilateral lingual–facial trunk has been described only sparsely in the literature. In this report authors describe and analyse a case of bilateral common lingual–facial trunk in the context of its anatomical, clinical and embryological implications. We also describe possible consequences in performance of elective and emergent surgical operations and modification in surgical techniques that should be considered. We believe that surgeons should be suspicious for this variation’s existence and keep alternative solutions in their armentarium

Desmoid tumor in Gardner's Syndrome presented as acute abdomen

BACKGROUND: Gardner's syndrome can occasionally be complicated with intra-abdominal desmoid tumor. These tumors usually remain asymptomatic but can exhibit symptoms due to intestinal, vascular and ureteral compression and obstruction. CASE PRESENTATION: A rare case of a 41-year-old male patient with Gardner's syndrome complicated with intra-abdominal desmoid tumor, which first presented as acute abdomen, is presented. CONCLUSION: Extra-abdominal manifestations of Gardner's syndrome along with a palpable abdominal mass would raise suspicion for the presence of a desmoid tumor in the majority of cases. In life-threatening cases, surgical treatment should be considered as a palliative approach, though the extent of excision remains debatabl

A study concerning morphometry of abdominal aorta branches and abdominal viscera: relations and correlation

Research interest on abdominal aorta branches and abdominal viscera morphometry is renewed by technological evolution and development of new radiologic and clinical applications including stent grafts and chemoembolisation materials. Despite that, data on morphometry of abdominal aorta branches and abdominal viscera are lacking. To investigate this subject authors performed a morphometric study on 50 adult fresh and embalmed Caucasian cadavers and examined abdominal aorta branches’, kidney and spleen morphometry. Our results on arteries’ morphometry did not differ significantly from those of the literature; yet, we discovered significant differences between fresh and embalmed cadavers on viscera morphometry, spleen and kidneys. We also found previously unreported correlations between abdominal aorta branches’ morphometric characteristics. Even more, we identified correlations between regional arteries and viscera morphometric characteristics, proposing a new factor determining viscera development. Finally, we performed an extensive literature review so to place our results in an anatomic, embryologic and, even more, a clinical context. We believe that our results add knowledge on abdominal aorta branches and viscera morphometry and are valuable for clinical, radiological and surgical applications including visceral arteries’ aneurysms investigation and treatment, chemoembolisation procedures, stent grafts design and transplantation.

Ansa pancreatica. Review of the literature

Ansa pancreatica is a reversed S-shaped pancreatic duct arising from the main pancreatic duct of Wirsung and ending at or near the minor duodenal papilla. Described for the first time in 1961, it is a rare anatomic variant of the pancreatic ducts system and is characterized by the absence of the accessory duct of Santorini. It probably serves as a counter measure after the accessory duct obliteration, in order to maintain sufficient pancreatic juice drainage. The literature concerning ansa pancreatica seems to be rather poor, compared to other anatomic variants and congenital anomalies of the pancreatic ducts. We tried to define the ansa pancreatica incidence among general population and highlight the possible differences between different populations, and to define its possible correlation with pancreatitis. The existing data correlate ansa pancreatica with recurrent acute pancreatitis and pancreatitis in alcoholics. Despite the lack of extended data, ansa pancreatica is a rare anatomic variant, proven to play an important role in certain clinical conditions

Vertebral artery variations revised: origin, course, branches and embryonic development

Background: The vertebral artery originates from the subclavian artery and is divided into four segments. The aim of this study is to investigate the anatomical variations in the course and branches of the vertebral artery. Materials and methods: A research was performed via PubMed database, using the terms: “variations of vertebral artery AND cadaveric study”, “variations of vertebral artery AND cadavers” and “anomalies of vertebral artery AND cadavers”. Results: A total of 24 articles met the inclusion criteria, 13 of them referring to variations of the origin of the vertebral artery, 9 to variations of the course and 3 to variations of its branches. On a total sample of 1192 cadavers of different populations, origin of the left vertebral artery directly from the aortic arch was observed at 6.7%. In addition, among 311 cadavers, 17.4% were found with partially or fully ossified foramen of the atlas for the passage of the vertebral artery, while the bibliographic review also showed variants at the exit site of the artery from the transverse foramen of the axis. Conclusions: Despite the fact that variations of both the course and the branches of vertebral artery are in most cases asymptomatic, good knowledge of anatomy and its variants is of particular importance for the prevention of vascular complications during surgical and radiological procedures in the cervix area