scholarly journals Variations in the Position and Length of the Vermiform Appendix in a Black Kenyan Population

ISRN Anatomy ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Philip Mwachaka ◽  
Hemed El-busaidy ◽  
Simeon Sinkeet ◽  
Julius Ogeng’o
Keyword(s):  
Surgical Procedure ◽  
Average Length ◽  
Vermiform Appendix ◽  
Human Anatomy ◽  
Black Africans

Background. Topography of the appendix influences its mobility, degree of mobilization of the cecum, and need for additional muscle splitting during appendectomy. Although appendectomy is a common surgical procedure, there is a paucity of data on its topography in black Africans. Methods. The position and length of the appendix and relation of the appendicular base with spinoumbilical line were determined in 48 cadavers obtained from the Department of Human Anatomy, University of Nairobi, Kenya. Results. The commonest appendicular types in males were retrocecal 10 (27%) while in females was subileal 4 (36.4%). The average length of the appendix was 76.5 ± 23.6 mm. The base of the appendix was located along, below, and above the spinoumbilical line in 25 (52.1%), 9 (18.8%), and 14 (29.2%) cases, respectively. Conclusion. The topography of appendix in Kenyans shows variations from other populations. Knowledge of these variations is important during appendicectomy.

scholarly journals Anatomical Pattern of Dorsal Metatarsal Arteries in a Black Kenyan Population

2019 ◽  
Vol 36 (03) ◽  
pp. 169-173
Author(s):  
Thomas Amuti ◽  
Lee Oyugi ◽  
Innocent Ouko ◽  
Ibsen Ongidi ◽  
Julius Ogeng'o
Keyword(s):  
Anatomical Variations ◽  
Human Anatomy ◽  
Bilateral Asymmetry ◽  
Black Africans ◽  
Dorsalis Pedis Artery ◽  
Dorsal Interossei ◽  
Arcuate Artery ◽  
The Right ◽  
The University ◽  
Formalin Fixed

Introduction Knowledge of anatomical variations in the origin and in the course of the dorsal metatarsal arteries (DMTAs) is valuable for many procedures, including reconstructive surgeries and flap selection. However, there is a paucity of data on these arteries among black Africans. Materials and Methods The present study studied the origin and the location of DMTAs in 30 formalin-fixed cadaveric feet of adult black Kenyans at the Department of Human Anatomy of the University of Nairobi, Nairobi, Kenya. Results Dorsal metatarsal arteries were present in all of the cases. Of the right dorsalis pedis artery (DPA), in the majority of the cases, the 1st DMTA arose as the continuation of the DPA, while the 2nd to 4th DMTAs were given off as branches from the arcuate artery (AA). On the left feet, in the majority of the cases, the 1st DMTA arose as the continuation of the DPA, while the rest were given off as branches from the AA. In relation to the dorsal interossei muscles, all of the the arteries were either within the muscle fibers (53%) or beneath them (47%), on the right side. On the left side, the 1st DMTA was above the muscles in 40% of the cases; within the muscles in 53%; and beneath the muscles in 7%. The 2nd and 3rd DMTAs were above the muscles in 57% and in 53% of the cases, respectively. Conclusion These results reveal that the DMTAs show variation in their origin and position relative to the dorsal interossei muscles. These variations display bilateral asymmetry.

Anatomy of the Lateral Plantar Ligaments of the Transverse Metatarsal Arch

2019 ◽  
Vol 41 (1) ◽  
pp. 109-114 ◽  
Author(s):  
Lyndon Mason ◽  
Malwattage Lara Tania Jayatilaka ◽  
Andrew Fisher ◽  
Lauren Fisher ◽  
Eric Swanton ◽  
...  
Keyword(s):  
Clinical Relevance ◽  
Average Length ◽  
Lower Limbs ◽  
Human Anatomy ◽  
Lateral Instability ◽  
First Metatarsal ◽  
Plantar Aspect ◽  
Lisfranc Ligament ◽  
The University ◽  
Middle Column

Background: While the anatomy of the Lisfranc complex is well understood, the lateral tarsometatarsal ligamentous structures, in contrast, are less well studied. Our aim in this study was to identify an anatomical explanation as to why the second to fifth metatarsals function as a unit in homolateral and divergent midfoot injuries. Methods: Eleven cadaveric lower limbs, preserved in formaldehyde, were examined at the University of Liverpool Human Anatomy and Resource Centre. Each of the lower limbs was dissected to identify the plantar aspect of the transverse metatarsal arch. Results: On removal of the long plantar ligament, the peroneal longus tendon was visible, as was its insertion onto the first metatarsal base. A lateral Lisfranc ligament (which was a transverse suspensory metatarsal ligament) spanned between the bases of the second and fifth metatarsals in all specimens with an average length of 33.7 mm and width of 4.6 mm. This ligament has not previously been described. It was noted that in all specimens, the long plantar ligament blended with the lateral Lisfranc ligament. In addition to the lateral Lisfranc ligament, separate intermetatarsal ligaments were identifiable connecting each metatarsal. The long plantar ligament provided a connection through the lateral Lisfranc ligament connecting the transverse and longitudinal arches of the foot. Conclusion: We found a plantar ligament that provided connection through the long plantar ligament of both the transverse and the longitudinal arches. It spanned from the second to the fifth metatarsal, which we believe may explain that in some cases, lateral instability can be overcome when the middle column is stabilized. Clinical Relevance: We suspect that in the majority of homolateral and divergent types of tarsometatarsal injuries that the lateral Lisfranc ligament remains intact and thus it has significant clinical ramifications.

scholarly journals Variations in the Formation of Hepatic Portal Vein: A Cadaveric Study

2020 ◽  
Vol 18 (2) ◽  
pp. 224-227
Author(s):  
Muna Kadel ◽  
Tinku Kumari Pandit
Keyword(s):  
Portal Vein ◽  
Average Length ◽  
Splenic Vein ◽  
Human Anatomy ◽  
Type I ◽  
Inferior Mesenteric Vein ◽  
Type Ii ◽  
Vein Formation ◽  
Hepatic Portal Vein ◽  
Hepatic Portal

Background: Portal vein drains blood from the abdominal part of alimentary tract, spleen, pancreas and gall bladder to the liver. It is normally formed by the union of superior mesenteric and splenic veins behind the neck of pancreas. Knowledge of variations regarding the formation of portal vein is very useful for surgeons to perform pancreas and duodenum and liver surgeries and for the interventional radiologist for catheter-based interventions. The objectives of this study are to disclose the variations in formation of hepatic portal vein and to measure the length of portal vein in cadavers. Methods: A descriptive cross sectional study was carried out on 40 embalmed cadavers in the Department of Human Anatomy, KIST Medical College, Lalitpur Nepal after taking ethical approval. The pattern of portal vein formation and its tributaries were identified and photographs were taken. The pattern of portal vein formation was classified as: Type I: Portal vein formed by the confluence of superior mesenteric and splenic vein ; Type II: portal vein formed by the confluence of superior mesenteric, splenic and inferior mesenteric vein . Data was analyzed by using SPSS version 20.Results: Type I pattern of portal vein formation was observed in 31 cadavers (82.5%) while Type II pattern was observed in 5 cadavers (12.5%). Average length of portal vein was 50.58mm. Conclusions: Portal vein shows variations in the pattern of formation which should be taken into consideration during pancreatico-duodenal surgeries and in the interpretation of abdominal angiographs.Keywords: Length; portal vein; variations.

scholarly journals Unusual case of De Garengeot hernia: femoral hernia containing purulent appendicitis in a 69-year-old man

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110284
Author(s):  
Longchao Yan ◽  
Yingyi Zhang
Keyword(s):  
Femoral Hernia ◽  
Surgical Procedure ◽  
Preoperative Diagnosis ◽  
Unusual Case ◽  
Single Incision ◽  
Vermiform Appendix ◽  
Rare Type ◽  
Common Procedure ◽  
Hernia Sac ◽  
De Garengeot Hernia

A De Garengeot hernia is a rare type of femoral hernia that involves a vermiform appendix within a femoral hernia sac. Because of the rarity of this disease, a standard surgical procedure has not been established, and most cases are diagnosed intraoperatively. Preoperative diagnosis of a De Garengeot hernia is quite difficult. Computed tomography is the most sensitive and specific technique among the available imaging tests for preoperative diagnosis of a De Garengeot hernia. Although a standard surgical procedure is lacking, prompt surgery has become the consensus. The most common procedure is the open anterior approach; this allows exploration of the hernia sac and rapid treatment of its contents, routine appendectomy through a single incision, and preperitoneal repair of the femoral hernia.

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
Keyword(s):  
Emergency Surgery ◽  
Average Length ◽  
Iliac Fossa ◽  
Anatomical Variations ◽  
Vermiform Appendix ◽  
Anatomical Location ◽  
Morphological Variations ◽  
Clinical Presentations ◽  
Abdominal Operations ◽  
The Right

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.

Low Insertion of the Cystic Duct in the Common Hepatic Duct as a Coincidence with an Onset of a Pancreatic Cephalic Carcinoma

2015 ◽  
Vol 69 (2) ◽  
pp. 94-99
Author(s):  
Aleksandar Sumkovski ◽  
Stojan Gjosev ◽  
Ljubomir Ognjenovikj ◽  
Meri Trajkovska ◽  
Goce Spasovski
Keyword(s):  
Cystic Duct ◽  
Surgical Procedure ◽  
Average Length ◽  
Hepatic Duct ◽  
Biliary Tree ◽  
Whipple Procedure ◽  
Common Hepatic Duct ◽  
Observation Study ◽  
Long Time ◽  
The Common

AbstractIntroduction. The normal anatomy of the cystic duct (CD) has been described a long time ago, but the basic description is valid up today: average length 2-4 mm, caliber 1-1.5 mm, and reduced volume by the spiral mu­­cous folds of Heister. Anatomic variants of the CD and its aberrant insertion lead to confusion during pre­opera­tive imaging examinations, and particularly to un­­pleasant situation during surgery, when the surgeon has to confirm positive identification of the anatomical struc­tures, in order to avoid iatrogenic biliary lesion. The aim of this prospective observation study was to evaluate the eventual bond between the low insertion of the CD in the common hepatic duct (CHD) and the onset of the pan­creatic cephalic carcinoma (PCC).Methods. In this study we examined 21 patients with PCC. The inclusion criteria was diagnosed PCC in ope­rable stage. The method for estimation of both, the ope­ra­bility and the site of insertion of the CD into CHD cons­isted of: ultrasonography (US), endoscopic retrograde cholangiopancreatography (ERCP), CT and MRI. Finally, the surgical procedure was extensive duodenopan­cre­a­tectomy, Whipple procedure. The surgical procedure was supplemented with periarterectomy and bilateral coeliac ganglienectomy in purpose of radical treat­ment and denervation.Results. Of the total of 21 patients, we revealed low in­sertion of the CD (LICD) in 6 patients (28%). In 4 pa­tients (3 male and 1 female), the LICD was presented with complete dilatation of the biliary tree, including CD, CHD and the gallbladder, while in 2 patients the CD and its low insertion were absent on the images-ERCP, CT. In these 2 patients the appearance was amid the cranial infiltration and growth of the carcinoma.Conclusions. Comparison with other reference radiolo­gical and anatomical studies, our results significantly di­ffer in the frequency of the appearance of the LICD. This may partially be due to different definitions and criteria referring to LICD. On the other hand, the observed diffe­rences may be caused by the eventually present connec­tion between the LICD and PCC. Therefore, further stu­dies with a larger number of participants are necessary (anatomical, pathological and genetic), to confirm or to deny the predicted bond between the LICD and PCC.

scholarly journals Therapeutical and Pharmaco-Chemical Conduct for Amyand Hernia

2020 ◽  
Vol 70 (12) ◽  
pp. 4224-4228
Keyword(s):  
Inguinal Hernia ◽  
Surgical Treatment ◽  
Polypropylene Mesh ◽  
Surgical Procedure ◽  
Preoperative Diagnosis ◽  
Vermiform Appendix ◽  
Amyand’S Hernia ◽  
Amyand Hernia ◽  
The Right

One of the rare findings regarding the hernial sac is the vermiform appendix. This pathology, defined as Amyand’s hernia, occurs in almost 1% of all inguinal hernia cases (0.19-1.7%). Usually, it is diagnosed intraoperatively, because the preoperative diagnosis is very difficult. We report the case of a 56-year-old man with a voluminous mass in the right inguinal-scrotal region. During the surgical procedure, an Amyand’s hernia was identified and we performed reduction of the hernia, herniorrhaphy and Lichtenstein Tension-Free Repair with polypropylene mesh. The case that we presented was type 1 according to Losanoff and Basson’s classification, but also to Rikki modified classification, with a very controversial management. Clinical evaluation and surgeon’s experience are the base of the surgical treatment. Keywords: vermiform appendix, inguinal hernia, surgical treatment

scholarly journals A Morphometric Study of Adult Human Sterna from the Galloway Osteological Collection

2020 ◽  
Vol 6 (2) ◽  
pp. 45-49
Author(s):  
Gonzaga Gonza Kirum ◽  
John Kukiriza ◽  
Gerald Tumusiime
Keyword(s):  
Average Length ◽  
Median Sternotomy ◽  
Human Anatomy ◽  
Morphometric Study ◽  
Xiphoid Process ◽  
Cross Sectional ◽  
Makerere University ◽  
Cardio Pulmonary Resuscitation ◽  
Significant Difference ◽  
Poor Outcomes

Background: Morphometric knowledge of the sternum is of great significance in cardiac surgery as variations in sternal dimensions have been considered a risk factor for translocation of suture material during median sternotomy, leading to poor outcomes. Fatalities attributed to subnor- mal sternal thickness have also been reported during sternal biopsies. Fractures of the sternum secondary to chest injury or cardio-pulmonary resuscitation may also be influenced by sternal thickness. Elongated xiphoid process can be mistaken for an epigastric mass which can be painful on palpation. Morphometric studies of African sterna are rare. The objective is to the study sought to describe the morphometry of adult sterna from the Galloway bone collection, Makerere University, Kampala, Uganda. Subjects and Methods: This study employed a descriptive cross sectional design to collect and analyze quantitative data. Eighty five dry adult sterna (75 males and 10 females) were examined at the Department of Human Anatomy, Makerere University. Data analysis at univariate and bivariate levels were performed using SPSS version 21.0 statistical software. Results:A significant difference in the average length of the mesosternum was found between males at 94.6 mm (SD 11.2) and females at 82.2 mm (SD 15.2) (P=0.002). Two cases (9.5%) presented with elongated xiphoid process and one (1.2%) with subnormal mesosternal thickness. Conclusions: Our study highlights the importance of knowledge of the sternal morphometry in sex identification, physical examination, sternal puncture and other thoracic procedures, calling for increased awareness of the findings.

Results of Laparoscopic Appendectomies Performed with the Use of Titanium Clips for Closure of the Appendicular Stump

2014 ◽  
Vol 86 (9) ◽  
Author(s):  
Marcin Strzałka ◽  
Maciej Matyja ◽  
Kazimierz Rembiasz
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Surgical Procedure ◽  
Elective Surgery ◽  
Average Length ◽  
Intraoperative Complications ◽  
Complication Rates ◽  
Appendicular Stump ◽  
Titanium Clips

AbstractNowadays laparoscopy is used frequently not only in elective surgery but also in abdominal emergencies, including acute appendicitis. There are several techniques used to close the appendicular stump during laparoscopic appendectomy.was to present the results of minimally invasive appendectomies performed with the use of titanium clips.Patients operated on laparoscopically for acute appendicitis with the application of titanium clips between October 2012 and December 2013 were included in the study. We reviewed retrospectively patients` data including: age, sex, duration of the surgical procedure and hospital stay, mortality, intraoperative and postoperative complication rates.There were 93 patients (mean age=33.8 years, SD=15.23) in the analyzed group, including 60 men (mean age=33.5 years, SD= 15.07) and 33 women (mean age=33.9 years SD=15.26). The aver-age duration of the surgical procedure was 66 min (SD= 33.15). The average length of hospital stay was 3.38 days (SD=1.62). No intraoperative complications were observed in the analyzed group. Post-operative complication rate was low (6 cases, 6.5%). No mortality was observed.Laparoscopic appendectomy with the application of titanium clips for closure of the appendicular stump is safe, associated with low complication rates and should be considered as a routine technique in everyday surgical practice.

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