A case of potentially lethal vascular variation in association with palmaris profundus muscle / 대한해부학회지

Arterial variations in upper limbs are often reported commonly. Superficial arterial variations accounting for 4.2% of all arterial variations are hazardous during any invasive procedures of the upper limb, from routine intravenous injections to surgeries. Arterial variations are usually associated with inverted or absent palmaris longus. Palmaris profundus, a rare anomalous variation of palmaris longus has been reported in carpal tunnel syndrome as its tendon was associated with median nerve in the carpal tunnel. The authors reported a unique variation in the upper limb arterial pattern—the presence of bilateral superficial brachioulnar artery associated with unilateral palmaris profundus muscle and an abnormal radicle of musculocutaneous nerve to the median nerve in the left side.

Celio-mesenteric trunk associated with giant omphalocele: surgical consequences / Tronco celíaco-mesentérico asociado con onfalocele gigante: consecuencias quirúrgicas

We report the first case of a newborn presenting with a celio-mesenteric trunk variation associated with a giant omphalocele. The celio-mesenteric trunk was unexpected and unseen during the staged surgical closure. After partial reintegration of the liver, the newborn presented refractory hypovolemia with anuria, leading to redo surgery. This procedure revealed ischemia of the liver and necrosis of the entire gastrointestinal tract except the colon. Despite treatment, including liver externalization, the infant did not survive. The autopsy revealed a celio-mesenteric trunk, a rare anomaly characterized by a common origin of the celiac axis and the superior mesenteric artery from the aorta. This association may explain the dramatic consequences of the staged closure procedure. Awareness of the association of celio-mesenteric trunk and omphalocele would allow the surgeon to take extra care during this delicate surgery.

Presentamos el primer caso de un recién nacido que presenta una variación del tronco celíaco-mesentérico asociada con un onfalocele gigante. El tronco celíaco-mesentérico fue inesperado y no se vio durante las etapas del cierre quirúrgico. Después de la reintegración parcial del hígado, el recién nacido presentó hipovolemia refractaria con anuria, lo que condujo a la repetición de la cirugía. Este procedimiento reveló isquemia del hígado y necrosis de todo el tracto gastrointestinal excepto el colon. A pesar del tratamiento, incluyendo la externalización hepática, el bebé no sobrevivió. La autopsia reveló un tronco celíaco-mesentérico, una rara anomalía caracterizada por un origen común del tronco celíaco y la arteria mesentérica superior, a partir de la aorta. Esta asociación puede explicar las dramáticas consecuencias del procedimiento durante las etapas del cierre. El conocimiento de la asociación de tronco celíaco-mesentérico y onfalocele permitiría al cirujano tomar especial cuidado durante esta delicada cirugía.

Unilateral Variation in the Branching Pattern of Right Axillary Artery.

Axillary artery and its branches are prone to have variations in their course. Knowledge about such variations are important for Radiologists in imaging techniques, Surgeons,Orthopedicians and Anesthetists in performing surgeries in the axilla and giving regional nerve blocks in the axilla.During dissection of a cadaver in the department of Anatomy, PSG IMS &R, Coimbatore, India. We observed a variation in the third part of right Axillary artery. From the common trunk, Subscapular artery, Anterior and Posterior circumflex humeral arteries and Profunda brachii artery arose. Third part of Axillary artery continued down as brachial artery. We are highlighting the variation in this study.

Arteria braquial superficial bilateral. una variación anatómica infrecuente con implicancias clínicas y quirúrgicas / Bilateral superficial brachial artery. a rare anatomical variation with clinical and surgical implications

Las variaciones del sistema arterial en el miembro superior son relevantes debido a la gran cantidad de procedimientos diagnósticos, invasivos y terapéuticos realizados en la actualidad. Reportamos una variante poco frecuente de la arteria braquial superficial (ABS) encontrada bilateralmente en los miembros superiores. En ambos miembros la ABS descendió superficial y lateral al nervio mediano y medial a la cabeza corta del músculo bíceps braquial. La ABS derecha terminó en la fosa cubital se unió a la arteria braquial en un tronco común, una variación anatómica rara de tipo isla, mientras que la ABS izquierda terminó en el antebrazo como arteria radial. La presencia unilateral de la ABS se ha informado con una frecuencia relativa, pero una variación bilateral es extremadamente rara. La relevancia de la embriología, incidencia y clínica de esta variación anatómica se discuten.

Variations of the upper limb arterial system are an important consideration due to the large number of invasive, diagnostic and therapeutic procedures performed in this region. We report a rare variant of the superficial brachial artery (SBA) found bilaterally in the upper limbs. In both limbs the SBA desending superficial and lateral of median nerve, and medial to the short head of bicep brachii muscle. Right SBA finished in the cubital fossa joined the deep brachial artery in a common trunk, a rare anatomical variation of island type, while the left SBA finished in the forearm and radial artery. The unilateral presence of the SBA reported with relative frequency, but a bilateral variation is extremely rare. The relevance of embryology, and clinical incidence of this anatomical variation are discussed.

Relationship between variation of donor hepatic artery injury and different procurement methods / 中华肝胆外科杂志

Objective To investigate the incidence of anatomic variations of hepatic artery and methods of procurement and reconstruction to prevent the accidental injury of the hepatic artery.Methods The clinical data of 843 patients receiving orthotopic liver transplantation (OLT) in our hos-pital from June 2001 to July 2006 were retrospectively analyzed. Liver and kidney separate procure-ment was performed for 148 cases and abdominal organ combined procurement in 695. The variations of the hepatic artery as well as the relationship between the anomalous hepatic artery and accidental in-jury of the hepatic artery were analyzed. Results Anatomic variations of hepatic artery which were most frequently observed, were the right hepatic artery originating from the superior mesenteric artery and left hepatic artery originating from left gastric artery. The rate of the anomalous hepatic artery concomitancy increased along with elevation in the rate of accidental injury. Conclusion Abdominal or-gan combined procurement can reduce the incidence of accident injury of hepatic artery. Familiarity of the he-patic arterial variation and careful anastomosis are important to reduce injury of the hepatic artery.

Arterial Variation in Upper Limb: Case Report / 체질인류학회지

The arterial variations of the upper limb are frequently encountered in the human body. However, the appearance of multiple variations in one limb is uncommon. The present arterial variations were found in the right upper limb of 86 years-old female cadaver during a routine dissection. The variations of the arterial patterns are as follows: 1. Two thyrocervical trunks from subclavian artery and the internal thoracic artery is rising from lateral branch of thyrocervical trunks. 2. Thoracoacromial artery was divided two branches and the lateral thoracic artery arises from the small of two branches. 3. The distance of bifurcation of the brachial artery is 14.9 mm from the inferior border of teres major muscle. Medial branch of the brachial artery passes along the median nerve and becomes radial artery. Lateral branch of the brachial artery passes along the median nerve and becomes ulnar artery. 4. Bifurcation of radial artery is occurred at the distance of 46.9 mm from styloid process of radius. Deep palmar branch of radial artery is bifurcated on dorsum of hand. Branches for supplying first and second fingers arise from superficial palmar arch. The arterial variations of the upper limb could be caused a several bleeding in intravenous injection or surgeries and a wrong diagnosis. The knowledge of the arterial variation of the upper limb should be decreased to raise clinical problems.