Unusual Path of Branches of Ilioinguinal Nerve: A Clinically Important Anatomic Variant

Ilioinguinal nerve is a collateral branch of lumbar plexus. Its anatomical variations in relation to adjacent musculoaponeurotic structures play a crucial role in the development of neuropathies associated with lower abdominal surgeries. In this report, we present a rare case of unusual course and branches of the ilioinguinal nerve, in a 55-year-old male cadaver. In the lateral part of inguinal canal ilioinguinal nerve gave three branches. Two of its branches pierced the external oblique aponeurosis, about 6 cm above the pubic symphysis, to supply the skin of the lower part of the anterior abdominal wall. Another branch pierced the conjoint tendon, in the medial part of the inguinal canal about 2 cm above the superficial inguinal ring. Knowledge of unusual path of these branches may be important to avoid injuries during the surgical repair of groin hernias. Further care should be taken while dealing with the conjoint tendon in the Bassini procedure.

A Rare Case of Undescended Caecum Accompanied by Looped Retroperitoneal Appendix

Intestinal malrotations are associated with various anatomical anomalies. We report a unique case wherein the caecum was located in the right lumbar region instead of the right iliac fossa. The ileo-caecal junction was also placed higher up. The appendix was ‘uncinate’ shaped, highly coiled and retroperitoneal with the absence of mesoappendix. Both, the caecum and appendix were supplied by ascending branch of the ileocolic artery instead of the descending branch. Further, we also observed that the ascending colon was very short and sub-hepatic in position. Such type of variations is of clinical and surgical importance in diagnosis and treatment of appendicitis.

An Unusual Termination of Facial Vein and Anterior Division of Retromandibular Vein into External Jugular Vein: A Case Report

Facial vein, being the largest vein of the face forms the common facial vein after joining with the anterior division of retromandibular vein below the angle of the mandible. Usually, it drains into the internal jugular vein. During routine dissection of head and neck region of a male cadaver, aged approximately 50 years, an unusual pattern in the termination of veins on the left side of the neck was observed. The formation, course and termination of external jugular vein were normal. The anterior division of retromandibular vein joined with external jugular vein about 5 cm above the clavicle and the facial vein opened into the external jugular vein about 2.5 cm above the clavicle. In addition, there was a thin venous communication between anterior division of retromandibular vein and external jugular vein. The superficial veins of the neck are often used for cannulation; either for intravenous infusion or for central venous pressure monitoring. Furthermore, these venous segments are used as a patch for carotid endarterectomies. Hence, a thorough knowledge of the normal anatomy and their variations may be useful for performing these procedures.

Abnormal Intraparotid Termination of Facial Vein and Its Clinical Importance

Facial vein is the main vein of the face. Though its origin is constant, it frequently shows variations in its termination. We report a rare type of variation of facial vein. The right facial vein coursed transversely across the masseter, superficial to the parotid duct and entered into the substance of the parotid gland, at its anterior border. Deep dissection of the gland revealed the abnormal termination of facial vein into the superficial temporal vein. The transverse facial vein drained into the facial vein. The superficial temporal vein after receiving the facial vein continued as retromandibular vein. Knowledge of this anomalous course and termination of facial vein may be important for the surgeons doing parotid, maxillofacial and plastic surgeries.

High Origin of Ulnar Artery with Unusual Superficial Course and Abnormal Additional Branches from the Superficial Palmar Arch

Though ulnar arterial variations are rare, superficial ulnar artery (SUA) is one of its commonest variations. During routine dissection in our department, we observed a unilateral case of SUA in a 70-year-old male human cadaver. It originated from the left brachial artery in the middle of the arm, 13cm above the medial epicondyle of humerus (15cm below the outer margin of first rib). From its origin, it passed downwards in the medial part of arm and forearm in a superficial plane compared to normal ulnar artery. In the hand, the SUA anastomosed with the superficial palmar branch of the radial artery, creating the superficial palmar arch. The superficial palmar arch gave additional branches to the thumb and index finger. Brachial artery divided into the radial and common interosseous arteries in the cubital fossa. The normal ulnar artery was absent. The existence of a SUA is undeniably of interest to the clinicians as well as to the anatomists. We hereby present a case of unilateral SUA along with a brief review of the literature and analysis of its clinical significance.