Double pouched, sigmoid gallbladder that can cause a diagnostic dilemma to radiologists: a case report / 대한해부학회지

Gallbladder shows frequent variations in position, shape, interior, and its duct system. These variations may go unnoticed lifelong; however, they may predispose it for cholecystitis and cholelithiasis. We observed a double pouched gallbladder in an adult male cadaver. The gallbladder was folded to have a sigmoid shape. It had two broad pouches: anterior and posterior and a narrow isthmus in between. Its anterior pouch was covered by peritoneum, whereas the posterior pouch was covered by extrahepatic connective tissue. We discuss the clinical and radiological importance of the case.

Surgical and radiological importance of a rare cysto-duodeno-colic peritoneal fold / 대한해부학회지

It is quite common to see abnormal peritoneal folds in the abdominal cavity. Some of them might compress or strangulate the viscera and others might determine the direction of the flow of peritoneal fluid, pus or blood. Many unusual clinically important peritoneal folds such as Ladd's band, cysto-gastro-colic fold, omento-cystic fold, and cysto-colic fold have been reported earlier. Knowledge of these folds is important for radiologists, gastroenterologists, and surgeons. We report an unusual cysto-duodeno-colic fold observed during our dissection classes. The fold was seen to compress the duodenum and colon. The fold extended from the descending part of the duodenum and the transverse colon to the gallbladder. It enclosed the entire gallbladder. A case similar to this has not been reported yet. It is important for the gastroenterologists and laparoscopic surgeons to be aware of this fold to avoid misdiagnosis and iatrogenic injuries.

Variant course of posterior circumflex humeral artery associated with the abnormal origin of radial collateral artery: could it mimic the quadrangular space syndrome?

Variations in the origin of axillary artery branches are common. But, distinctly abnormal course of its posterior circumflex humeral branch is rare. We are reporting a case of posterior circumflex humeral artery (PCHA) originating from the axillary artery, passing through lower triangular space to reach the scapular region where it accompanied the axillary nerve and posterior circumflex humeral vein to pass around surgical neck of humerus, deep to the fibers of deltoid. Other variations observed in this specimen were the radial collateral artery arising from the PCHA, middle collateral artery arising directly from the brachial artery and absence of profunda brachii artery. PCHA forming a hair pin loop, traversing through lower triangular space instead of quadrangular space taking a long course is being reported for the first time. Further, the clinical and surgical importance of this case especially in relation with quadrangular space syndrome and relevant literature is discussed.