scholarly journals Morphological Variations in the Anatomy of Caecum and Appendix - A Cadaveric Study

2012 ◽  
Vol 01 (01) ◽  
pp. 030-035 ◽  
Author(s):  
Arindom Banerjee ◽  
I. Anil Kumar ◽  
Arunabha Tapadar ◽  
M Pranay

Abstract Background : Appendicitis is one of the most common clinical conditions that require emergency surgery. Variations in anatomical location of appendix can result in different clinical presentations. Anatomical and topographical variations of the caecum are also known to occur. Anatomical variations in caecum have been observed along with the appendix in this study. Aims: To study the variations in the size, shape, position and arterial supply of the caecum and appendix in individuals of different sex and age, a thorough knowledge of which will aid surgeons in performing various abdominal operations in adults and children. Material and methods: The study was carried out on 25 adult cadavers over a period of 3 years. The anatomy of caecum and appendix was studied in detail. Results : The normal position of caecum and appendix in adult cadavers was found to be in the right iliac fossa. In all specimens the shape of caecum was adult (ampullary) type and it was supplied normally in all cases from a branch of the superior mesenteric artery. The appendix was found in the retro-caecal position in majority of cases with a complete meso-appendix in four and an additional blood supply via the artery of Sesachalam was found in two cases. Conclusions: Vermiform appendix is characterized by variability of its location and morphology. The ultimate position of the appendix is influenced by the changes in position and shape which the caecum undergoes during development and growth. The present study observed the appendix and caecum to be found in their normal positions in majority of cases. The average length of caecum and appendix was found to be more in males as compared with females. Appendicitis is one of the most common diseases that need emergency surgery. Variations in anatomical position cause different clinical presentations. A thorough knowledge of normal anatomy and variations of the caecum and appendix is very important to the surgeon performing abdominal operations in adults, children and infants as it helps them to make optimal diagnosis of various pathological conditions related to these organs and treat accordingly.

2020 ◽  
Vol 8 (12) ◽  
pp. 842-846
Author(s):  
Yehouenou Tessi T. Romeo ◽  
◽  
Asaad El Bakkari ◽  
Adeyemi A. Boris ◽  
Khadija Ben El Hosni ◽  
...  

Mucocele of the appendix is a descriptive term for mucinous distension of the appendiceal lumen (vermiform appendix) regardless of the underlying pathology. It refers to the progressive retrograde dilatation of the vermiform appendix with concomitant intraluminal accumulation of the mucoid substance. It is an uncommon pathology that occurs in both sexes. it especially poses the problem of differential diagnosis in particular in women because of the location of clinical symptoms in the right iliac fossa. The incidence is estimated between 0.2 % and 0.4 % of the appendectomied specimens.The estimated incidence is approximately 1/1 000 000/year. The disease onset is usually after the age of 40 years and more frequently affects females.The means of medical imaging are mainly ultrasound and scanner. On CT typical mucocele appears as a cecal-based, rounded and well-defined mass, thin-walled, with fine parietal calcifications CT density is variable, from fluid to tissue. A stercolith is sometimes visible at the base of the appendix. The wall of the mucocele may be thickened, irregular, taking the contrast there may be peri-appendicular inflammation, which may be inflammatory or tumor, without specificity.The treatment of unbroken appendicular mucocele is surgical, preferably by laparotomy than laparoscopy. The appendectomy is performed, without breaking the appendix, with complete resection of the meso-appendix, and sampling for cytology of the peritoneal fluid.


2021 ◽  
Vol 9 (2.3) ◽  
pp. 8012-8019
Author(s):  
THIAM Sokhna Astou ◽  
◽  
MAR Ndeye Bigué ◽  
YACOUBA GARBA Karim ◽  
SECK Issa Dior ◽  
...  

Bronchial distribution in the upper lobe of the right lung is subject to many anatomical variations. The control of these variations is essential for the interpretation of endoscopic examinations. It also offers a better guarantee for safe surgery during segmentations in the right upper lobe. In this preliminary work, the operation of 30 heart-lung blocks treated by the injection-corrosion method, 100 CT chest and dissections of 3 resected specimen of right upper lobectomy, allowed us to study the bronchial distribution in the upper lobe of the right lung as well as their anatomical variations in melanoderm subjects. Our results were as follows: out of the 133 specimens, the right upper lobar bronchus was born on average 1.8 cm from the tracheal bifurcation, with an average length of 1.75 cm. There were 6 termination modes, dominated by bifurcations, which involved 52% of the specimens, and in 5 modes. Trifurcation accounted for 47.37% of cases. There was a case of quadrifurcation. These results allowed us to discuss anatomical variations of the bronchial shaft of the upper lobe of the right lung. Taking into account these variations will allow to avoid pitfalls and accidents during endoscopic examinations, medical imaging and pulmonary exeresis. KEY WORDS: Bronchi-Right Upper Lobe-Anatomy-Variations- Endoscopy-Imaging-Surgery.


2018 ◽  
Vol 159 (19) ◽  
pp. 768-772
Author(s):  
Tamás Vass ◽  
Attila Zaránd ◽  
Dániel Horányi ◽  
László Harsányi

Abstract: Diverticulitis of the vermiform appendix is a rare disease with clinical features often similar to conventional acute appendicitis. The importance of appendiceal diverticulosis is the fact that it can lead to an early and a higher incidence of perforation and therefore a higher mortality rate, in contrast to acute appendicitis alone. In this study we present the clinicopathology, diagnosis and therapy of the disease with a review of the literature. A 65-year-old woman presented to the emergency department with a 48-hour history of intermittent pain in the right iliac fossa. Abdominal ultrasound raised the possibility of acute appendicitis but because of the relative asymptomatic state of the patient, the lack of fever and rebound tenderness we started observation. After 2 days with episodic abdominal pain, the patient was taken to the operating theatre for laparoscopic exploration. Intraoperatively, multiple diverticula were noted on the appendix and appendectomy was performed. Histopathological examination revealed diverticulosis and inflammation of the appendiceal wall. Due to the possible complications, the difficult preoperative diagnosis and its frequent association with appendiceal neoplasm, appendiceal diverticulosis requires special attention. For asymptomatic cases, incidentally diagnosed intraoperatively or discovered by radiology prophylactic appendectomy is recommended. Orv Hetil. 2018; 159(19): 768–772.


Esculapio ◽  
2020 ◽  
Vol 16 (03, july 2020-Septmber 2020) ◽  
Author(s):  
Aliya Zahid ◽  
Brishna Khan ◽  
Saira Munawar

Objective: To find out gross anatomical variations of embalmed cadaveric livers. Methods: Present study was conducted in dissection halls of Anatomy departments of Allama Iqbal Medical College, Lahore, Sahiwal Medical College, Sahiwal and Fatima Jinnah Medical University, Lahore during 2016-2019. In this study, 74 livers were dissected out from embalmed cadavers and preserved in 10% formalin. Different morphological variations were observed in livers which included presence of accessory lobes, accessory sulci, notches, changes in size and shape of lobes. Liver specimens were photographed and classified according to Netter's classification of morphological variations of liver. Results: The hepatic morphological variations observed included accessory fissures in the right, left, caudate and quadrate lobes of the liver, accessory lobes, elongated left lobe, hypoplastic left lobe, multiple deep diaphragmatic sulci, pons hepatis, Reidel's lobe, notched borders and bilobed caudate lobe. Conclusion: The knowledge of various variations in morphology of cadaveric livers may help the radiologists to make accurate interpretation of the radiological images, thus minimizing the chances of incorrect reporting. It may also be helpful to the hepatobiliary surgeons to be aware of the morphological variations on the liver surface to avoid surgical complications. Key Words: Embalmed cadaveric livers, accessory lobes, accessory fissures


Folia Medica ◽  
2017 ◽  
Vol 59 (1) ◽  
pp. 106-109 ◽  
Author(s):  
Atoni Dogood Atoni ◽  
Charles Aidemise Oyinbo

Abstract Documented anatomical variations are important not only for the study of the subject of anatomy, but also in clinical situation. This knowledge would aid surgeons in planning a preoperative strategy for surgical procedures and reconstructive surgery. The right forearm of a 35-year-old embalmed male cadaver present a splitting of the median nerve in the proximal 1/3 of the forearm to form medial and lateral divisions that accommodate an anomalous muscle. The split median nerve reunites at the distal 1/3 and continues as a single nerve. The anomalous muscle arises by muscle fibers from flexor digitorum superficialis and inserted by tendon into flexor digitorum profundus. There was no such variation in the left forearm. The knowledge of such anatomical variations is important to clinicians and surgeons in interpreting atypical clinical presentations and avoiding unusual injury during surgery.


2020 ◽  
Vol 1 (1) ◽  
pp. 86-90
Author(s):  
Muhammad Tariq

Background: The radial artery is the smaller terminal branch of the brachial artery. It is one of the most commonly used arteries for various interventions. Anatomical variations exist and can predispose patients to iatrogenic injury if the operator is unaware of normal radial artery morphology. The present study focuses on giving detailed information about radial artery measurements in our local population. Methods: This was a cross-sectional observational study, conducted in the anatomy department of Jinnah Medical College Peshawar from 2017 to 2018. This study was conducted on 42 formalin-fixed cadavers, yielding 84 upper limbs. The radial artery was dissected and studied; length, external and internal diameters were measured. Data was entered in SPSS v20 and analyzed. Results: The mean age of the study population was 36 ± 11.25. Male to female ratio was 1:1. The most common site of origin of the radial artery was distal to head of the radius. The right radial artery was longer than the left. The right radial artery was broader in males as compared to females with a p-value of <0.05. The external and internal diameters of the radial artery decreased gradually from start to the endpoint for both the genders. The external diameters of the left radial artery were greater than those on the right side. The right radial artery had a larger internal diameter than the left side. Conclusion: The anatomy and morphology of radial artery have many documented variations. Radiologist and surgeons should have a good understanding of normal morphological variations of radial artery.


Author(s):  
Gyanaranjan Nayak ◽  
Biswa Bhusan Mohanty ◽  
Saurjya Ranjan Das

  Objective: Pterion is an area formed by the union of frontal, parietal, temporal, and sphenoid bones. It exhibits variations in the sutural pattern of fusion of constituent bones. Basing on this, the pterion can be classified into four varieties. According to Murphy, these are sphenoparietal, frontotemporal, stellate, and epipteric. The anatomical location of the pterion is necessary for the surgical management of extradural hemorrhage, aneurysm, and brain tumors located in the anterior and middle cranial fossae.The purpose of this study is to find out the prevalence of different varieties of pterion and determine the position of pterion using anatomical landmarks.Methods: The present study included fifty skulls of unknown age and sex. The skulls were studied macroscopically for the anatomical variations of pterion. The distance between the center of the pterion to the midpoint of zygomatic arch and pterion to the frontozygomatic suture was measured using Vernier calipers.Results: The sphenoparietal variety was the most common variety of pterion found in the study followed by the epipteric variety and the stellate variety, respectively. The distance between pterion and back of the frontozygomatic suture was found to be 3.48 ± 0.21 cm on the right side and 3.41 ± 0.16 cm on the left side. The distance between pterion and the midpoint of upper border of the zygomatic arch was found to be 4.01 ± 0.19 cm on the right side and 3.94 ± 0.2 cm on the left side.Conclusion: The findings will be helpful for radiologists and neurosurgeons.


2014 ◽  
Vol 03 (04) ◽  
pp. 198-202
Author(s):  
R. Sudha

Abstract Background and aim of the study: The clavicle is a subcutaneous bone most frequently fractured at the junction of its lateral and middle third of the shaft. Anatomical variations of the curvatures of clavicle can be of relevance for surgical correction procedures like intramedullary or internal plate fixation. The aim of the present study was to observe variations of length and medial and lateral angles of curvatures of the clavicle in a sample of South Indian population. Materials and methods: One hundred and thirteen unpaired clavicles (50 left side, 63 right side) of unknown sex and age were studied from the bone collection available at Anatomy departments of Annapoorana Medical College, Vinayaka Mission's Medical and Homeopathy Colleges, Salem. To measure the angles, Parsons method and a protractor was used. Length of the clavicle was measured with a Vernier Calipers. Observation: The average length of the clavicle was found to be 13.74cm left side and 13.76cm on the right side. The average medial angle of the clavicle on the left side is 146° and right side is147.5°. The average lateral angle on the left side is 144° and right side is 142.05°.The total average angle of the clavicle is 290.30° on left side and 289.59° on right side. Conclusion: The average length of the clavicle on the right side is more than the left side. The medial angle on the right side and the lateral angle on left side are more than corresponding opposite sides. These variations can be useful for the orthopaedic surgeons during the surgical correction procedures of clavicle fractures.


2020 ◽  
Vol 6 (1) ◽  
pp. 43-48
Author(s):  
Khizer Hussain Afroze M ◽  
Sangeeta M ◽  
Varalakshmi K.L

Introduction: The lumbrical muscles are unique in their functions in being only intrinsic muscles which bridges between the palmar and dorsal surface. This unique property endows them in performing fast, alternating movements and fine tuning digit motion. The aim of this study was to evaluate the anatomical variations in the morphology and architecture of lumbricals and to discuss its clinical implications. Subjects and Methods: This study was conducted on 74 disarticulated upper limbs during routine dissection of cadavers in the Department of Anatomy of MVJMC & RH. The dissection was carried out based on the steps as per the Cunningham’s manual. Results: Variations in lumbricals were observed in 12 specimens (8 in right side & 4 in left side). The variation encountered were the proximal origin of lumbricals in 4 specimens (5.41%), Split insertion in one specimen (1.35%), bipennate second lumbrical in two specimens (2.70%), accessory belly of first lumbrical in 4 specimens (5.41%) and hypertrophied lumbrical in one specimen (1.35%). Conclusion: Variations of the lumbrical can present with wide range of clinical presentations like compression of neurovascular structures as in hypertrophy, carpal tunnel syndrome as in proximal origin and accessory belly of lumbrical.


VASA ◽  
2011 ◽  
Vol 40 (5) ◽  
pp. 404-407
Author(s):  
Maras ◽  
Tzormpatzoglou ◽  
Papas ◽  
Papanas ◽  
Kotsikoris ◽  
...  

Foetal-type posterior circle of Willis is a common anatomical variation with a variable degree of vessel asymmetry. In patients with this abnormality, carotid endarterectomy (CEA) may create cerebral hypo-perfusion intraoperatively, and this may be underestimated under general anaesthesia. There is currently no evidence that anatomical variations in the circle of Willis represent an independent risk factor for stroke. Moreover, there is a paucity of data on treating patients with such anatomical variations and co-existing ICA stenosis. We present a case of CEA under local anaesthesia (LA) in a 52-year-old female patient with symptomatic stenosis of the right ICA and coexistent foetal-type posterior circle of Willis. There were no post-operative complications and she was discharged free from symptoms. She was seen again 3 months later and was free from complications. This case higlights that LA should be strongly considered to enable better intra-operative neurological monitoring in the event of foetal-type posterior circle of Willis.


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