A Case Report on Hepatopancreatic Anomaly with its histomorphological study in Adult Cadaver

The pancreas is a soft, lobulated and mixed gland. As the liver and pancreas develop together from the hepatopancreatic bud it is common that congenital anomalies of liver and pancreas exist together. This study was done during routine practical dissection where a band of tissue was found extending from the head of the pancreas to the root of the Mesentry. On histological examination the tissue was confirmed to be pancreas. It is seen that the hepatic bud grows at the expense of the ventral pancreas. In the present study, we found an atrophied left lobe of liver and an abnormally rare and large uncinate process of pancreas.

A Study On The Morphological Variations Of The Human Liver And Its Clinical Implications In Gujarat Region

Background:liver is a soft, friable and largest gland in the body, occupying the upper part of the abdominal cavity just beneath the right diaphragm. The greater part of it is situated under cover of the ribs, extending to the left to reach the left diaphragm. Objective: to determine gross anatomical variations of liver and their clinical and surgical implications. To study variations in lobes, fissures and accessory lobes were observed. Material And Methods:a total of 50 formalin-fixed adult human livers, irrespective of the sex, were studied over a period of three years from Dr M K shah medical college. These livers were specifically observed for any variant or anomalous surface morphology. Result:out of 50 specimens, 16 were considered normal without any ac-accessory fissures, lobes, or presence of a pones hepatis. 34 livers had one or more morphological variations.14 liver has accessory fissure, 10 liver are present with riedel’s lobe present in liver, 10 liver are present with pons hepatic. Conclusion:liver being the largest abdominal organ, the knowledge of its normal and variant morphology is essential for the clinicians. In general, accessory hepatic fissures/sulci are potential sources of diagnostic errors during imaging. On ultrasound or computerized tomography, any collection of fluid in these fissures may be mistaken for a liver cyst, intrahepatic hematoma, or liver abscess, which would require further radiologic workup.

Placenta succenturiata. Reporte de un caso / Succenturiate placenta. Case report

Resumen La placenta succenturiata es una anomalía morfológica de la placenta donde se presentan uno o más lóbulos accesorios por fuera del cuerpo placentario, pueden ser de diferentes tamaños y estar conectados mediante vasos sanguíneos a la placenta principal. El lóbulo accesorio se desarrolla a partir de las vellosidades coriónicas no asociadas al corion leve. La incidencia estimada a nivel mundial es de 1.04% y los principales factores de riesgo asociado a esta entidad son edad materna avanzada y el antecedente de haberse sometido a fertilización in vitro. Presentamos el caso de una paciente de 18 años con diagnóstico de placenta succenturiata con inserción marginal y velamentosa del cordón umbilical, la cual tuvo la finalización de la gestación por parto eutócico en el que se obtuvo recién un nacido eutrófico y sano, con tercer período de trabajo de parto prolongado y retención placentaria, por lo que se realizó alumbramiento manual, y se obtuvo la placenta completa con la presencia de un lóbulo accesorio con conexiones vasculares con el cuerpo placentario. En conclusión, la placenta succenturiata es una anormalidad morfológica relativamente rara, de diagnóstico clínico y morfológico en el puerperio inmediato, sin embargo, debe buscarse de manera intencionada mediante ultrasonido Doppler color en el período prenatal debido a que esta variedad de placenta conlleva a riesgos que pueden comprometer la salud y la vida tanto del feto como de la madre.

Abstract Placenta succenturiate is a morphological anomaly of the placenta where one or more of the lobes are present at a distance, which can be of different sizes and are connected by blood vessels to the main placenta. The accessory lobe develops from the chorionic villi that did not involute from the mild chorion. The estimated incidence worldwide is 1.04%. This entity has been associated with two main risk factors, advanced maternal age and women who have undergone in vitro fertilization. We report the case of a finding of placenta succenturiate in the postpartum period, in an 18-year-old woman in her first pregnancy, with vaginal delivery, eutrophic and apparently healthy newborn was obtained. During the third period of labor the patient presented placental retention, for which manual delivery was performed, obtaining a complete placenta that upon inspection was observed the presence of an accessory lobe in the membranes, which had vascular connections with the main placenta. In conclusion, placenta succenturiata is a relatively rare morphological abnormality, diagnosed in the postpartum period, but it can be diagnosed intentionally by color Doppler ultrasound in the prenatal period. This variety of placenta carries many risks that can compromise the health and life of both the fetus and the mother.

A Study Of Anatomical Variations In Patterns Of Fissures And Lobes In Human Lungs: A Cadaveric Study With Clinical Significance

The lungs are essential organs of respiration and are situated in the thoracic cavity on either side of themediastinum. The arrangement of lung tissue into lobes by fissures facilitates the movements of the lobes inrelation to one another thus helping in uniform expansion of the whole lung in inspiration. The fissure may becomplete, incomplete, or absent altogether. In the presence of these major variations, the left lung may have threelobes and the right lung may have four or only two lobes. The identification of the completeness of the fissure isimportant before lobectomy, individuals with incomplete fissure are more prone to develop postoperative airleaks. Out of total 84 lungs studied, 46 (55%) were from left side and 38 (45%) were from right side. Out of 38 rightlungs examined, the horizontal fissure was absent in 10 lungs (26%) and incomplete in 24 lungs (63%). Completehorizontal fissure was seen in 4 lungs (10%). Oblique fissure was absent in 2 lungs (1%) and incomplete in 24lungs (63%). The complete oblique fissures was reported in 12 lungs (32%). Out of 46 left lungs, the incompleteoblique fissure was noted in 32 lungs (70%) and complete oblique fissures were present in 10 lungs (22%). Theoblique fissure was absent in 4 lungs (9%) Studies have recorded the importance of fissural anatomy in explainingvarious radiological appearances of interlobar fluid, extension of fluid into an incomplete fissure, or spread ofdiseases through them. Recognition of laterality of fissure in the lung improves understanding of pneumonia,pleural effusion, collateral air drift along with disease, carcinoma spreading within lung, postoperative airleakage in incomplete fissure and misinterpretation of accessory fissure as atelectasis or consolidation, andsegmental localization of the lung for thoracic, cardiothoracic surgeons for planning segmental resections orpulmonary lobectomy.

Accessory Lobe of Right Lung.

Anatomical variations of lungs in the form of Accessory lobe and abnormality in the fissures are important for the surgeons to avoid possible injuries to the neighbouring structures. We report a case of Accessory lobe of right lung between middle and lower lobe in a male cadaver which was found during routine dissection in the Anatomy department, PSG IMS & R. Fissure and lobes of left lung was normal. Anatomical knowledge of such variations are helpful for Cardiothoracic surgeons in lobectomies, surgical resections involving individual segments and for Radiologists for interpreting X – rays,CT & MRI scans.

A Rare Case With Multiple Variations Of Liver And Associated Arteries.

Variations of liver, its arterial supply and branching pattern of coeliac trunk are not uncommon as separate entity but this case presents several variations. During routine dissection, a multi-lobular liver, with irregular inferior margin, was observed occupying only right upper quadrant of the abdomen. An extra (accessory) lobe was hanging from its inferior surface. Common hepatic artery was giving eight branches, six on left side and two on right side. Five of the left branches were entering liver but none was passing through porta hepatis. Coeliac trunk showed tetrafurcation; the additional branch was supplying pancreas and transverse colon. Knowledge of these variations or combinations is important in open access surgeries, endoscopic surgeries and diagnostic and interventional radiology of the region.