ABSTRACT
This study aimed to clarify the anatomy of middle rectal artery and pelvic vasculature patterns, and to provide schematic information in a manner applicable to the total mesorectal excision. Forty sides of pelvis from 20 formalinembalmed cadavers (10 male, 10 female) were dissected, and all the pelvic vasculatures from the internal iliac artery were investigated, focusing on the middle rectal artery. Middle rectal arteries were classified into major types depending on their vascular origins. Each type was subdivided into minor types according to variability of the pelvic vasculature. A middle rectal artery was identified in 18 out of 20 cadavers, and in 25 out of 40 pelvic sides. In most cases, the middle rectal artery originated from the internal pudendal artery or inferior gluteal artery. These two arteries arose directly from the anterior trunk of the internal iliac artery or were bifurcated from the gluteal-pudendal trunk. In rare cases, these arteries arose from the posterior trunk of the internal iliac artery. The other origins of the middle rectal artery included the gluteal pudendal trunk, inferior vesical artery, internal iliac artery, obturator artery, and the prostatic artery, and the pelvic vasculatures in these cases also presented variability. The detailed anatomical findings related to the middle rectal artery and pelvic vasculatures are noteworthy for their improved clinical applicability.
ABSTRACT
Understanding anatomic variations in neurovascular structure inside the femoral triangle is crucial for regional anesthesiologists performing femoral nerve block. During routine dissection of a cadaver, an ascending branch of the lateral circumflex femoral artery with an anomalous course passing through the femoral nerve, specifically the posterior division, was identified inside the femoral triangle on the left thigh. The novel variation identified in this study occurred in an early stage of prenatal development. Recognition of this anatomic variation will be helpful for reducing unexpected complications during the femoral nerve block and the tensor fascia latae flap. Penetration of the posterior division of the femoral nerve by the arterial branch might cause pain or paresthesia of the medial aspect of the leg in the distribution of the saphenous nerve.
ABSTRACT
Understanding anatomic variations in neurovascular structure inside the femoral triangle is crucial for regional anesthesiologists performing femoral nerve block. During routine dissection of a cadaver, an ascending branch of the lateral circumflex femoral artery with an anomalous course passing through the femoral nerve, specifically the posterior division, was identified inside the femoral triangle on the left thigh. The novel variation identified in this study occurred in an early stage of prenatal development. Recognition of this anatomic variation will be helpful for reducing unexpected complications during the femoral nerve block and the tensor fascia latae flap. Penetration of the posterior division of the femoral nerve by the arterial branch might cause pain or paresthesia of the medial aspect of the leg in the distribution of the saphenous nerve.