ABSTRACT
Tensor fascia suralis muscle is an anomalous muscle located in popliteal fossa. The muscle may arise from any of the hamstring muscles and is inserted into the crural fascia or tendoclacaneus. We found tensor fascia suralis muscle in a male cadaver taking origin from medial side of tendon of biceps femoris muscle. The tendinous origin was then transformed into a well defined fusiform belly in the roof of popliteal fossa. After traversing downwards and medially the muscle again became tendinous to get inserted into deep fascia of leg. Bilateral presentation of the anomalous muscle is not yet documented in literature. The anatomical relation of the muscle explains its great clinical importance. The tendinous origin was anteriorly related to sciatic nerve and the muscle belly to the tibial nerve. Sural nerve and short saphenous vein were in lateral relation to the muscle. Contraction of muscle in the roof of popliteal fossa may lead to sciatic, tibial or sural nerve neuropathy. The muscle can confuse the physician of a soft tissue mass or an aberrant vessel. Hence, the bilateral presence of tensor fascia suralis muscle is documented for further references. Clinical Significance: The precise knowledge of anatomy of popliteal region is mandatory for the surgeons to perform safe and uncomplicated surgery in and around popliteal fossa and also for radiologist for correct radiographic interpretations.
ABSTRACT
Introducción: El secuestro pulmonar (SP) ha sido tratado por muchos años con cirugía convencional efectuando remoción del tejido pulmonar ectópico y ligadura de los vasos sanguíneos aberrantes que nacen desde la aorta. Existe evidencia establecida, especialmente en literatura de habla inglesa que apoya el uso de la embolización arterial transcatéter mediante dispositivo para ocluir el vaso anómalo, como una opción de tratamiento seguro y definitivo para el SP intralobar. Objetivo: Mostrar nuestra experiencia pionera de la técnica de tratamiento del SP por medio de embolización transcatéter. Caso clínico: Presentamos los casos clínicos de dos adolescentes, de 13 y 14 años y de un recién nacido de 26 días de vida, portadores de SP intralobar, cuyos diagnósticos se realizaron a través de Tomografía Axial Computarizada (TAC) con contraste, tratados mediante embolización arterial transcatéter, con buen resultado y sin complicaciones en el seguimiento precoz y tardío. Conclusión: Con este tratamiento se logra en los pacientes afectados de SP resultados definitivos, menos invasivos y sin complicaciones al seguimento.
Introduction: Pulmonary sequestration (PS) has been treated for many years with conventional surgical removal of the ectopic lung tissue and ligation of aberrant vessels that arise from the aorta. There is evidence, especially in English-language literature that supports the use of transcatheter arterial embolization through a device for occlusion of the anomalous vessel, as a safe option and definitive treatment for intralobar PS. Objective: To show our experience pioneering the technique of PS treatment through transcatheter embolization. Case report: The case reports of two teenagers aged 13 and 14 and a 26-day-old newborn that developed intralobar PS are described. The diagnosis was made through computerized axial tomography (CT scan) and successfully and without complication, during early and long term follow-up, treated by arterial embolization transcatheter. Conclusion: The use of transcatheter arterial embolization is a less invasive and definitive treatment for patients with PS.
Subject(s)
Humans , Male , Adolescent , Female , Infant, Newborn , Embolization, Therapeutic/methods , Bronchopulmonary Sequestration/therapy , Embolization, Therapeutic/instrumentation , Bronchopulmonary Sequestration , Tomography, X-Ray Computed , Treatment Outcome , Blood Vessels/abnormalitiesABSTRACT
Objective To study the diagnostic value of contrast-enhanced CT scan with split bolus for the ureleropelvic junction obstruction(UPJO) caused by aberrant vessel of kidney.Methods 52 patients with UPJO underwent contrast-enhanced CT scan with split bolus.The aberrant vessels and its origin as well as the relationship between aberrant vessels and UPJO were observed comparatively with the results of surgery.Results In 52 cases,CT showed UPJO caused by aberrant vessl of kidney in 14 cases,including accessory renal arteries in 10,ovarian artery originated from left renal artery in one,right accessory renal artery in one and gonad veins in 2.CT findings were corresponded to operations in all these 14 cases.The sensitivity and specificity of CT in evaluating UPJO were 100% respectively.Conclusion The UPJO caused by aberrant vessel of kidney can be diagnosed accurately by contrast-enhanced CT scan with split bolus,which can be offered for surgical treatment for UPJO.The patient's CT dose can be decreased with split bolus.
ABSTRACT
The cause of ureteropelvic junction obstruction(UPJ) is almost due to intrinsic factor. But a small percentage of UPJ obstruction have extrinsic obstruction as a result of a crossing renal aberrant vessel. The diagnosis of UPJ obstruction by aberrant vessel is usually made at surgery because the urographic findings are nonspecific and difficult to find cause. For the purpose of detecting aberrant vessel as a cause of UPJ obstruction, authors examined 20 patients with color Doppler ultrasonographic equipment, then cause of obstruction was confirmed at the time of surgery, from July 1991 to February 1994. In seven of twenty patients aberrant vessel was detected by color Doppler ultrasonographic equipment. Among the seven patients, only three cases were caused directly by aberrant vessel, color Doppler examination disclosed a vessel or vessels at the tapering distal end of UPJ. In other two patients, aberrant vessel was detected but it was not direct cause of UPJ obstruction. Even in two of seven patients, aberrant vessel was not detected at the time of surgery. However in one of thirteen patients with no color Doppler signal at the UPJ, aberrant vessel was confirmed in surgical field. Sensitivity was 75 % and specificity was 75 % as detecting aberrant vessel by color Doppler ultrasonographic equipment. We believe that color Doppler examination is a useful method in demonstration of aberrant vessel as a cause of UPJ obstruction, although accuracy was low.