A Case of the Inferior Mesenteric Artery Arising from the Superior Mesenteric Artery in a Korean Woman

Anatomical variations of the inferior mesenteric artery are extremely uncommon, since the inferior mesenteric artery is regularly diverged at the level of the third lumbar vertebra. We found a rare case in which the inferior mesenteric artery arose from the superior mesenteric artery. The findings were made during a routine dissection of the cadaver of an 82-yr-old Korean woman. This is the tenth report on this anomaly, the second female and the first Korean. The superior mesenteric artery normally arising from abdominal aorta sent the inferior mesenteric artery as the second branch. The longitudinal anastomosis vessels between the superior mesenteric artery and inferior mesenteric artery survived to form the common mesenteric artery. This anatomical variation concerning the common mesenteric artery is of clinical importance, performing procedures containing the superior mesenteric artery.

The pattern of arrangements and distributions of the superior mesenteric artery in a Nigerian population / Patrón de disposición y distribución de la arteria mesentérica superior en la población de Nigeria Anozeng

This study was to ascertain the pattern of arrangements and distributions of the superior mesenteric artery (SMA) in a Nigerian population. Seventy-five cadavers certified as Nigerians were obtained from the dissecting room of the Department of Anatomy, University of Calabar after ethical approval from the Institution's Ethics Committee. Their abdomens and their contents were excise to expose the vessels. Based on the pattern of arrangements of the SMA, the cadavers were grouped into three (A, B, and C). Group A had 45 cadavers and this constituted 60 percent which were similar to the commonly documented patterns. Groups B and C had 20 and 10 cadavers respectively constituting 26.7 percent and 13.3 percent pattern of arrangement, some of which have not been documented before. In conclusion these peculiar patterns in this population are to be noted in surgical procedure, since damage to these variant vessels may result in severe haemorrhage that may lead to other complications.

Este estudio consistió en determinar el patrón de disposición y distribución de la arteria mesentérica superior (AMS) en una población de Nigeria. Setenta y cinco cadáveres certificados como nigerianos se obtuvieron de la sala de disección del Departamento de Anatomía de la Universidad de Calabar, después de la aprobación ética del Comité Ético de la Institución. Su abdomen y sus contenidos fueron disecados para exponer los vasos. Basado en el modelo de disposición de la AMS, los cadáveres fueron agrupados en tres grupos (A, B y C). Grupo A tuvo 45 cadáveres y estos constituyeron el 60 por ciento los cuales fueron similares a los patrones comúnmente documentados. Los Grupos B y C con 20 y 10 cadáveres respectivamente, constituyeron el 26,7 por ciento y 13,3 por ciento del patrón de disposición, algunos de los cuales no se han documentado antes. En conclusión, estos patrones peculiares en esta población han sido observados en procedimientos quirúrgicos, ya que el daño a estas variantes de vasos pueden resultar en hemorragias graves que pueden conducir a otras complicaciones.

Transcatheter Coil Embolization of an Arc of Buhler Aneurysm

We report the findings of a patient with an asymptomatic Arc of Buhler (AOB) aneurysm, which was successfully treated by transcatheter coil embolization. An abdominal CT and angiography revealed an intact pancreaticoduodenal artery arcade (PDAA) and an anomalous communication between the SMA and celiac axis, termed an AOB. An aneurysm was observed at the origin of the AOB and treated with a transcatheter embolization using coils. A follow-up CT imaging confirmed the total occlusion of the aneurysm with a patent PDAA. The successful results of this treatment suggest that the endovascular therapy of an AOB aneurysm with a celiac axis occlusion and an intact PDAA is feasible and safe.

Anatomic variations of the hepatic arteries in 200 patients done by angiography.

OBJECTIVE: To evaluate and classify hepatic artery variations of 200 patients by angiography. MATERIAL AND METHOD: Celiac and superior mesenteric artery (SMA) angiographic studies of 200 patients at King Chulalongkorn Memorial Hospital (KCMH) from January 2003 to July 2004 were retrospectively reviewed. Anatomic findings were classified according to Michels and Hiatt's classifications. RESULTS: The vascular anatomy of the liver was classified according to two different established systems. Hepatic arterial patterns were analyzed in order offrequency discovered as the following; normal pattern in textbook descriptions 80.5%, a replaced or accessory right hepatic artery (RHA) originating from the SMA 11.5% and a replaced or accessory left hepatic artery (LHA) originating from the left gastric artery (LGA) 5.5%. In 0.5% of the cases, there was a combination of variations of both RHA and LHA. Variants of the common hepatic artery (CHA) arising from the SMA were found in 0.5%. 1.5% of cases were not classified by either Michels or Hiatt's classifications. CONCLUSION: The present study had the same results by the higher rates of normal hepatic anatomy with lower rates of other types compared to Michels and Hiatt's studies. In addition, the authors found cases of rare variations that were not classified by either Michels or Hiatt but were previously reported by other publications.

Numerical variation of the celiac trunk and anatomical variation in origin and course of the dorsal pancreatic artery

A numerical anomaly of the celiac trunk and anatomical variation in origin, and course of the dorsal pancreatic artery were encountered during a routine upper abdomen dissection of a 62-year-old male cadaver. The aim of this study was to describe a rare celiac trunk and dorsal pancreatic artery variation in detail, which can be a guide and precaution during operative procedures in this region. The abdominal aorta, its branches and the pancreas were cut and removed just above the celiac trunk and below the superior mesenteric artery to investigate the vascular distribution of the pancreas in detail. The celiac trunk divided into the left gastric, hepatic, splenic, and dorsal pancreatic arteries. The anatomical variation of the celiac trunk and splenic artery makes it vulnerable to iatrogenic surgery. Knowledge of the existing aberrations is important in planning and conducting surgical procedures

Sindrome de la arteria mesenterica superior: Utilidad de la TAC helicoidal / Superior mesenteric artery syndrome: Using of Helical CT

Se informa un caso clínico de síndrome de arteria mesentérica superior (AMS) en un paciente masculino de 15 años de edad, quien presenta obstrucción intestinal alta luego de perder 6 kilogramos de peso. Se revisan sus características clínicas e imaginológicas, con énfasis en la utilidad de la TAC helicoidal

Anastomosis anómala entre las arterias hepática y mesentérica superior / Anomalous anastomosis between the hepatic and superior mesenteric arteries

Variaciones anatómicas en las arterias de las regiones hepática y peripancréatica han sido descritas, en el 34 por ciento de los pacientes sometidos a angiografías preoperatorias del tronco celiaco y de la arteria mesentérica superior. Estas variaciones pueden complicar seriamente algunas intervenciones, como la cirugía laparoscópica, al alterar la disposición de los elementos en el hilio de los órganos; o hacer impracticable algunos actos quirúrgicos complejos, como el transplante hepático o la resección del páncreas. En este trabajo, presentamos un raro caso de anastomosis entre las arterias hepática y mesentérica superior. Este vaso anómalo, de trayecto tortuoso, dispuesto detrás del cuello del páncreas, mide 21 cms. de largo, presenta un calibre irregular y en la parte inicial de su trayecto da origen a las ramas gastroepiploica derecha y pancreático-duodenal superior. En el texto se discuten las posibles causas embriológicas que explican esta variación anatómica