Variations of Middle Segmental Artery of Human Kidney and Clinical Significance.

Aim: To assess the arterial pattern of middle segmental artery and its relation with collecting system in the human kidneys. Materials and Methods: We studied 50 fresh human Kidneys by corrosion cast techniques. We used different colour coded moulding granules of butyl butyrate, red for artery, blue for vein and black for collecting system of the human kidneys. 20% solution of butyl butyrate in acetone was injected into renal vessels and ureter of each kidney. Injected kidneys were kept immersed in concentrated Potassium Hydroxide solution for corrosion to obtain the endocasts. These endocasts were cleaned under the running tap water and observed macroscopically. Results: We observed three types of variations in arterial pattern of middle segmental artery namely Middle Segmental Artery Type-1 (MSAT1), Middle Segmental Artery Type-2 (MSAT2), Middle Segmental Artery Type-3 (MSAT3) and they were seen in 29(58%), 14(28%), 6(12%) kidneys respectively. We also observed three different variations in relation between middle segmental artery and collecting system namely Middle Segmental Artery Group-1 (MSAG1), Middle Segmental Artery Group-2 (MSAG2), Middle Segmental Artery Group-3 (MSAG3) and they were seen in 32%, 24%, 42% kidneys respectively. Conclusion: Anatomical knowledge of these variations is of valuable contribution for uro-surgeon in performing more and more conservative renal surgeries which lead to preservation of healthy and functional renal parenchyma and prevent intraoperative and post-operative complications.

Sixth cervical vertebra with bilateral double foramen transversarium and non-bifid spine: a rare case.

Anatomical knowledge of variations is of utmost clinical importance to all of us as they may be one of the reasons as etiological as well as of surgical importance. Vertebral region also presents many variations. Foramen transversarium are typical feature of cervical vertebrae and give way to neurovascular bundle, like vertebral artery, vertebral veins and sympathetic plexus around them throughout. Foramen transversarium and spine or spinous process of cervical vertebrae are important to all of medical specialists as well as for surgeons specially the surgeons dealing with head & neck surgeries. Knowledge of anatomical/surgical variations is very important for neurosurgeons and radiologists for reporting and planning for surgeries as this type of variation if ignored may be a cause for fatal or undesirable outcome of the surgical procedure or may lead to a different planning/approach at the time or during the surgical procedure. In the present case we observed very uncommon finding of bilateral double foramen transversarium as well as a nonbifid spinous process in sixth cervical vertebra which is extremely rare. Right and left both main foramen transversarium were bilateral symmetrical and rounded in shape. Right accessory foramen transversarium was complete while left was incomplete. Finding of present study is important in neurosurgery for posterior approaches of the cervical vertebrae and also useful for radiological studies to avoid erroneous counting of cervical spines in clinical observations as surface landmark.

Anatomical Variations In Arterial Pattern Of Lower Segmental Artery And Its Relation With Collecting System.

Aim of our study to observe the arterial pattern of lower segmental artery and its relation with collecting system. 50 fresh human Kidneys were studied by corrosion cast method. Moulding granules of butyl butyrate dissolved in acetone for 24 hours and prepared 20% homogenous solution. Solution was injected into renal vessel and ureter. Injected Kidney was corroded in concentrated potassium hydroxide solution and cleaned with running water. We observed three dimensional endocasts of collecting system and renal vessel. We found 5 types of variation in arterial pattern of lower segmental artery namely LSAT1, LSAT2, LSAT3, LSAT4, LSAT5 and they were seen in 70%, 4%, 2%, 4% and 20% Kidneys respectively. We also found two types of variation in relation between lower segmental artery and collecting system namely LSAG1 and LSAG2. LSAG1 seen in 80% Kidneys and LSAG2 in 20% Kidneys.The finding of our study is helpful for urosurgeon in intrarenal operations, endourological stone removal, renal trauma management and to avoid post operative complications.

Unilateral Triple Renal Veins and Bilateral Double Renal Arteries- An Unique Case Report.

A precise knowledge of the vascular variations of human kidney is essential for the surgeon and radiologist to avoid complication during interventional radiological procedure, renal transplantation, renal trauma and other urological procedures. The present case report is regarding unilateral variation of renal vein and bilateral variation of renal artery. During routine cadaveric dissection of abdominal region, we observed three renal veins in right kidney. All right renal veins were emerging from hilum of kidney and drained in inferior vena cava where as in left Kidney venous drainage is normal. In right Kidney both main and accessory renal artery arose from abdominal aorta. Left main renal artery arose from abdominal aorta with left accessory renal artery arising from left middle suprarenal artery which is branch of coeliac trunk. In this case right ureteropelvic junction is seen to be compressed in between right accessory renal artery and right lower renal vein which crossed anteriorly with right middle renal vein crossing posteriorly this condition may cause hydronephrosis. The above finding to be reported in a single case is rarely seen. This is a valuable contribution from anatomical knowledge to operative procedures.