scholarly journals Anatomical Variation in Extrahepatic Biliary Apparatus

2020 ◽  
Vol 6 (2) ◽  
pp. 25-28
Author(s):  
Shambhu Nath Jha ◽  
Saif Omar

Background: For several years, the pathology of the biliary system has been the focus of prolonged study. Largely due to their surgical relevance and the simplicity with which they can be treated in cholecystectomies. While interest in extrahepatic bile ducts has been intensified, very rare studies have been performed on the Indian subcontinent. The anatomical differences of the extra-hepatic biliary area were defined in this study, as these variations are important throughout surgical techniques such as laparoscopic cholecystectomy, thus minimising post-operative difficulties. The objective is aim of the research was to observe anatomical differences in the extrahepatic biliary system in Indian cadaveric specimen samples. Subjects and Methods : Sample content consisted of 100 human cadavers of any sex that were dissected. Cadaver specimens from the dissection room were examined. Cadaver specimens were obtained from Mata Gujri Memorial Medical College, Kishanganj, Bihar, Department of Anatomy. By the traditional method of dissection, they were studied. Results: In the current study, the smallest gall bladder observed was around 25ml, while the largest gall bladder was around 120ml. On average, our study recorded around 50 ml of the gall bladder. Congenital anomalies of the gall bladder included Intrahepatic, Double, Bilobed and separate mesentery. Further, the pathological findings accounted for 20% of total cases and a solitary pathology involving carcinoma was noted. Conclusion: Anatomical variants of the extrahepatic biliary system are widespread and are important for surgeons to prevent injury as critical structures through surgical operations and increase surgical results by recognising them.

2014 ◽  
Vol 6 (2) ◽  
pp. 91-94
Author(s):  
Kosuri Kalyan Chakravarthi ◽  
Nelluri Venumadhav ◽  
KS Siddaraju

Background: The thinnest portion of the medial wall of the orbit is Lamina orbitalis ossis ethmoidalis which separates the ethmoidal sinuses from the orbit. Congenital bony malformation of orbit and anatomical variation of ethmoidal sinuses are important in terms of the risk of complication development during endoscopic sinus surgery and to understanding the pathophysiology and spread of sinus disease.Materials and Methods: Accordingly the present study was designed to fi nd out the congenital malformation of medial wall of the orbit in relation to lamina orbitalis ossis ethmoidalis. The study was carried out using 100 dried adult human skulls and twenty six human cadavers irrespective of sex were obtained from the Department of Anatomy - Mayo Institute of Medical Sciences-Barabanki, Department of Anatomy - Melaka Manipal Medical College - Manipal and Department of Anatomy - KMCT Medical College, Manassery - Calicut.Results: In three skulls (2.380%) we noted unilateral unusual hole at the junction of medial wall and roof of orbit with dimensions of 2.3 cm long and 1 cm height in two skulls and another unusual vertical hole at the anterior part of medial wall and roof of orbit with dimensions of 2 cm height and 1 cm width. We also noted few ethmoidal cells extended in to the orbital plate and fovea ethmoidalis of the frontal bone.Conclusion: Congenital defective formation of bony orbit and variable anatomy of paranasal sinuses noted in this study is may be due to the defective formation of Lamina orbitalis ossis ethmoidalis from the lateral part of the nasal capsule near the fronto ethmoidal suture such comprehensive knowledge is necessary to understand the various disorders of this region and to avoid complications during surgical procedures involving this area.DOI: http://dx.doi.org/10.3126/ajms.v6i2.10534Asian Journal of Medical Sciences Vol.6(2) 2015 91-94


Author(s):  
Francisco J. Lucas ◽  
Vicente Carratalá ◽  
Ignacio Miranda ◽  
Cristobal Martinez-Andrade

Abstract Background Advances in wrist arthroscopy and the emergence of novel surgical techniques have created a need for new portals to the wrist. The aim of this study was to define and verify the safety of the volar distal radioulnar (VDRU) portal. Description of the Technique The VDRU portal is located ∼5 to 10 mm proximal to the proximal wrist crease, just on the ulnar edge of flexor carpi ulnaris tendon and radial to the dorsal cutaneous branch of the ulnar nerve. The ulnar styloid marks the distal point of the portal. Methods An anatomical study was performed on 12 upper extremity specimens of 6 human cadavers. Iatrogenic injuries of neurovascular structures potentially at risk were assessed, and the distance from the portal to these structures was measured. Results No iatrogenic injuries of the structures at risk occurred. Mean distances from the VDRU portal to the ulnar neurovascular bundle, the radial branch of the dorsal sensory branches of the ulnar nerve (DSBUN), and the ulnar branch of the DSBUN were 9.29 ± 0.26 mm, 8.08 ± 0.25 mm, and 10.58 ± 0.23 mm, respectively. There were no differences between left and right wrists. The distances from the VDRU portal to the ulnar neurovascular bundle and the ulnar branch of the DSBUN were significantly shorter in women; this distance was not less than 7 mm in any case. Conclusions The VDRU portal is safe, reproducible, and facilitates the implementation of various techniques related to triangular fibrocartilage complex pathology.


2021 ◽  
Vol 28 (03) ◽  
pp. 277-281
Author(s):  
Bushra Shaikh ◽  
Imamuddin Baloch ◽  
Azhar Ali Shah ◽  
Abdul Sami Mirani ◽  
Parkash Lal Lund ◽  
...  

Objective: To compare the frequency of port site wound infection following gall bladder removal through umbilical and epigastric port in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Surgical Unit 2, Ghulam Muhammad Mahar Medical College, hospital Sukkur. Period: 1st November 2019 to 30th October 2020. Material & Methods: All cases who underwent four port laparoscopic cholecystectomy were enrolled in two groups. All procedures were performed under general anesthesia. As the last event of surgery gall bladder was retrieved in a glove bag through umbilical port in group A and through epigastric port in group B, both under direct camera vision. Wound infection was considered if there was 3 to 5 grade of wound according to Southampton wound grading system (Figure-1) on 5th postoperative day. All demographics and outcome variables were recorded. Results: Age ranged from 20 to 60 years with mean age of 38.875±8.11 years, BMI 29.973±5.12 Kg/m2, duration of surgery 50.656±8.41 mins and Southampton score was 1.044±1.07 in Group A and mean age of 38.560±6.23 years, BMI 27.437±5.04 Kg/m2, duration of surgery 48.920±8.67 mins and Southampton score was 0.856±0.92 in Group B. In group A, 18 (5.7%)patients developed port site wound infection in contrast to 5 (1.6%) patients in group B (P= 0.006). Conclusion: We conclude that epigastric port retrieval of gall bladder following laparoscopic cholecystectomy results in less port site infection.


1970 ◽  
Vol 29 (2) ◽  
pp. 78-84
Author(s):  
FH Chowdhury ◽  
MR Haque ◽  
NKSM Chowdhury ◽  
MS Islam ◽  
Z Raihan ◽  
...  

Cranio vertebral (CV) junction is one of the critical sites for surgery. It's anatomy, physiological aspects and pathological involvement varies in a wide range of margins. Common problems are developmental anomalies, traumatic involvement, inflammatory, infective and neoplastic lesion. Management of these problems varies a lot from each other. Aim of the article is to overview the pathologies in this area and to study presentations, investigations, surgical procedures and results of these pathologies. We prospectively analyzed 32 cases of Cranio-vertebral (CV) region surgery in the Department of Neurosurgery Dhaka Medical College Hospital and Mitford Hospital, Dhaka, from 2000 to 2008. In our series, male and female ratio was 7.2:1. Pathologies were atlanto- axial dislocation (AAD), Chiari malformation type –I, schwannoma, meningioma, hydatid cyst and tuberculosis. Common clinical findings were- neck pain, quadriparesis, quadriplegia, hand atrophy, autonomic dysfunction and hypertension. Various types of surgical procedures were done in this series according to the pathology. Death was in 01 case, neurological deterioration seen in one case, 2 cases were neurologically stable and 28 cases (87.5%) improved neurologically where one was non useful improvement (Frankel grade-C). Complete pre operative radiological study is a very important adjunct for a successful surgical result. Proper evaluation of patients with selection of appropriate surgical procedures along with safe surgical techniques are the necessary things for successful surgery in this area. DOI: http://dx.doi.org/10.3329/jbcps.v29i2.7952 (J Bangladesh Coll Phys Surg 2011; 29: 78-84)


2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Georgi P. Georgiev ◽  
Svetoslav A. Slavchev ◽  
Iva N. Dimitrova ◽  
Boycho Landzhov

High division of the median nerve proximal to the carpal tunnel, also known as a bifid median nerve, is a rare anatomical variant with an incidence between 1 and 3%. In order to study the incidence of this anatomical variation in the Bulgarian population, we examined the upper limbs of 51 formol-carbol fixed human cadavers and also 154 upper limbs undergoing carpal tunnel decompression. We detected one case of bifid median nerve during anatomical dissections and two cases in patients with carpal tunnel syndrome. In one of the clinical cases, the anatomical variation was detected preoperatively by MRI. We discuss different variations of this nerve and emphasize their potential clinical implications.


2016 ◽  
Vol 5 (2) ◽  
pp. 26-28
Author(s):  
Zubaida Gulshan Ara ◽  
ASM Shafiqul Islam ◽  
Umme Kulsum Sharmin Zaman ◽  
Anjuman Ara ◽  
Reeva Aireen Busreea

This cross sectional descriptive study was done to see the length of the cervix in Bangladeshi cadaver to find out the anatomical variation and to compare it with other study findings. 60 post mortem specimens containing female genital organs particularly uterine cervix were collected by purposive sampling technique from cadavers of different age groups. All the collected specimens were fixed in 10% formalin solution. This study was carried out in the department of Anatomy, Mymensingh Medical College from July 2006 to June 2007. Both gross and fine dissections were performed to measure the length of the uterine cervix. We compare our study findings with that of the references. Maximum mean length of the cervix was found in the 13-45 years age group. It was 2.89 cm. CBMJ 2016 July: Vol. 05 No. 02 P: 26-28


2021 ◽  
Vol 20 ◽  
Author(s):  
Laishram Sophia ◽  
Darshita Singh ◽  
Neha Xalxo ◽  
Anjoo Yadav ◽  
Sneh Agarwal ◽  
...  

Abstract Background Variations in the upper limb arterial pattern are commonplace and necessitate complete familiarity for successful surgical and interventional procedures. Variance in the vascular tree may involve any part of the axis artery of the upper limb, including the axillary artery and brachial artery or its branches, in the form of radial and ulnar arteries, which eventually supply the hand via anastomosing arches. Objectives To study the peculiarities of the arterial pattern of the upper limb and to correlate them with embryological development. Methods The entire arterial branching of forty-two upper limbs of formalin fixed adult human cadavers was examined during routine dissection for educational purposes, conducted over a 3-year period in the Department of Anatomy, Lady Hardinge Medical College, New Delhi. Results The study found: 1) One case in which a common trunk arose from the third part of the axillary artery, which immediately splayed into four branches (2.4%); 2) High division of the brachial artery into ulnar and radial arteries, in 3 cases (7.1%); 3) Pentafurcation of the brachial artery into ulnar, interosseus, radial, and radial recurrent arteries and a muscular twig to the brachioradialis in 1/42 cases (2.4%); 4) Incomplete Superficial Palmar arch in 3/42 cases (7.1%); and 5) Presence of a median artery in 2/42 case(4.8%) Conclusions This study observed and described the varied arterial patterns of the upper limb and identified the various anomalous patterns, supplementing the surgeon’s armamentarium in various surgical procedures, thereby helping to prevent complications or failures of reconstructive surgeries, bypass angiography, and many similar procedures.


2015 ◽  
Vol 4 (1) ◽  
pp. 11-18
Author(s):  
Tahmina Hossain ◽  
Md Ashraf Ul Huq

Purpose: Laparoscopy is gaining popularity over laparotomy in various surgical conditions. Now a day, an increasing number of diagnostic and therapeutic surgical procedures are being done laparoscopically. The aim of this study was to assess the safety and feasibility of laparoscopy in children.Materials and Methods: This retrospective study was carried out in the Department of Pediatric Surgery of Dhaka Medical College Hospital over a period of 52 (Fifty two) months from June 2009 to August 2013. A total of 123 patients were operated laparoscopically up to 12 years of age for different surgical conditions. Data was collected from the hospital records and analyzed retrospectively.Results: Out of these 123 laparoscopically performed cases, Appendectomy was performed in 39 cases, closure of internal inguinal ring for Inguinal Hernia was done in 36 patients, 20 patients underwent Cholecystctomy, 16 patients had laparoscopic procedures for impalpable Undescended Testis (UDT), 5 patients were operated for Adnexal Mass of which one case was converted into open procedure due to technical difficulties and 1 for Pancreatic Pseudo cyst. Diagnostic Laparoscopy was performed for 2 patients with Biliary Atresia and 4 patients for Ambiguous Genitalia. Median age of the patients was 6.08 years (ranging from 2 months to 12 years of age). The length of post operative hospital stay was 2-3 days. All the laparoscopic procedures for Inguinal Hernia and impalpable UDT were performed as day care surgery. Operative and post operative complications were minimal. Other advantages of the laparoscopic procedures were smaller incisions, incidental diagnosis of other associated pathology, lesser post operative pain, earlier oral feeding, quicker mobilization and a better cosmetic result.Conclusion: With the recent development of laparoscopic surgical techniques and equipments, laparoscopic surgical procedures are becoming popular day by day and can be performed safely for both diagnostic and therapeutic purposes in pediatric surgical patients.J. Paediatr. Surg. Bangladesh 4(1): 11-18, 2013 (January)


2021 ◽  
Vol 11 (3) ◽  
pp. 294-309
Author(s):  
I. Deikalo ◽  
D. Osadchuk ◽  
O. Karel ◽  
M. Handzhalas

Minimal invasive endoscopic technologies are used in the treatment of patients with biliary pancreatitis with complicated cholangitis and biliary sepsis. 56 patients were treated for the period 2014 - 2018, aged 65.5 ± 15.18 years. ERCP was performed in 31 (55,3%) patients, in 13 (23,2%) - surgical intervention was performed without contrast of extrahepatic bile ducts. Papillotomy in 52 cases (96,4%) was performed by string papilloma and in 4 (7,1%) - by needle. In all cases, subtotal papilloprotectomy was performed [1], supplemented by balloon sphincteroplasty. In the I group, the patients included patients with biliary pancreatitis clinic, in group II patients with clinic of biliary sepsis, in the III group patients with purulent cholangitis clinic, biliary sepsis and septic shock. In the 1st and 2nd groups of patients, mortality was not observed. In the 3rd group, 3 patients died (37,5%). The rest of the patients are discharged from the hospital in a satisfactory condition. A decrease in the level of markers of hepatitis cytolysis (AlAT, AsAT, GGTP, L-FABP) was observed during surgical procedures without ERCP, indicating the toxic effect of contrast on the liver parenchyma. L-FABP is a highly informative marker for hepatocyte cytolysis and can be used as a criterion for hepatic insufficiency and prognosis of biliary sepsis. The high efficiency of transpacillary endoscopic surgical techniques in the treatment of biliary pancreatitis and biliary sepsis was noted.


2021 ◽  
pp. 11-13
Author(s):  
Sutia Indra Nath ◽  
Baruah Anuradha ◽  
Borah Ankita

Background: Anatomical variations and congenital anomalies of the pancreatic ducts are often detected as incidental ndings in asymptomatic patients and are commonly encountered in radiological investigations. Anatomical knowledge of the pancreatic ducts and its variations are important to avoid pancreatic injury during surgical and investigative procedure. The Objectives: aim of the present study is to study anatomical variation of the pancreatic ducts. Methods: The study was done in the department of Anatomy, Assam Medical College, Dibrugarh, Assam. 50 specimens were collected, (35 nos perinatal and 15 nos adult). A thorough morphological study of the pancreatic duct system was carried out and the results were recorded. Variations of the pancreatic ducts & their diffe Results: rent types correlate with the previous studies to some extent. Conclusion: Knowledge of the pattern and anomaly of the pancreatic ducts will add in the long list of variations of the pancreas. It will be helpful for safe and effective diagnostic and therapeutic interventions and prevention of inadvertent organ damage or ductal injury.


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