Sub-hepatic Caecum with Extra-pelvic Looped Sigmoid Colon: An Embryological and Clinical Perspective

Introduction: We encountered variation in the placementof large intestine in abdominal cavity of a 76-years-old malecadaver during dissection of abdominal cavity. The workwas performed in Department of Anatomy during routineMBBS teaching sessions. The aim of this paper is to reportco-existence of error of mid-gut development and alongwith variant topo-morphology of sigmoid colon in the samecadaver.Case Report: Sub-hepatic caecum with high riding vermiformappendix with absent ascending colon was seen on the rightside of abdominal cavity. Concomitantly on the left side of theabdominal cavity dilated, looped sigmoid colon occupied theleft hypochondrium, left lumbar region and left iliac fossa. Wereport these findings along with the embryological basis andclinical significance.Conclusion: An insight about the errors in development ofmid-gut resulting into the variant topography of caecum willfacilitate surgeons and radiologists in prompt diagnosis andquick modification of the protocol during invasive procedures.

Unusual Formation Of Median Nerve And Occurrence Of Musculo-Aponeurotic Band In The Course Of Median Nerve In Arm: A Clinico-Anatomical Study

Median nerve is one of the commonly involved nerves in peripheral neuropathy of the upper limb. Peripheral neuropathies may occur due to various intrinsic (medical conditions like diabetes mellitus & Guillian Barre syndrome) and extrinsic (nerve entrapment) causes. This study reports an unusual course of median nerve which can be considered as cause of such entrapment neuropathy. During routine MBBS dissection on a 76 years old male cadaver unusual formation and variant course of median nerve was noted. In present study unusual relation of the medial root of median nerve with axillary artery was found at the origin and secondly the nerve was found coursing under the musculo-aponeurotic band located on the antero-medial side of lower one-third of the right arm. These observations are important as the aponeurotic band may compress the median nerve and may results in entrapment neuropathy. The comprehensive knowledge of possible variant anatomical relations of median nerve are of great importance to understand the cause of symptoms and to facilitate early diagnosis and prompt management of patient presenting with median nerve compression.