The retroperitoneal anastomoses of the gonadal veins in human foetuses.

In the retroperitoneal space the gonadal veins form a collateral circulation that has a great clinical impact on sclerotherapy or surgical ligation of varicoceles. The aim of this study was to examine the communications of the gonadal veins (according to classification, frequency of appearance, gender and syntopic differences) in human foetuses of both sexes (71 males and 59 females) aged 4--6 months of intrauterine life. On the right side the most frequently were found the gonadal-periureteral anastomosis (23%) and the gonadal-perirenal anastomosis (22%). A gonadal-lumbar anastomosis on the right side appeared in 7% of cases. On the left side the most frequent (37%) was the gonadalperirenal anastomosis, more frequently occurring as an ovarian-perirenal anastomosis (48%) than as a testicular-perirenal anastomosis (29%). Gonadal-periureteral anastomoses were found in a quarter of cases. Gonadal-lumbar anastomoses were observed in 7% of individuals. On the left side the gonadal-mesenteric inferior anastomosis was specifically observed (21%) as an ovarian-mesenteric inferior anastomosis (24%) and a testicular-mesenteric inferior anastomosis (19%). The cross-communications between the right and left gonadal veins (7%) were more frequently as the bilateral testicular (9.7%) than as the bilateral ovarian one (3%). In female foetuses gonadal-perirenal anastomoses occurred with statistically greater frequency than gonadal-periureteral anastomoses (p<=0.05). The frequency of cross-communications of the gonadal veins was three times greater in male foetuses (p

Morphometry of the pancreas in human foetuses.

With the use of conventional anatomical dissection, radiography, digital and statistical analysis, morphometry and skeletopy of the pancreas was carried out in 60 human foetuses of both sexes (28 female, 32 male) between the 17th and 40th week of intrauterine life. The material was fixed in a 10% formalin solution. The age of the foetuses was determined by crown-rump (CR) length measurement on the basis of the Iffy et al. tables. Photographic documentation was made and then digitally processed in the Computer Image Digital Analysis System. The following parameters were taken into account: the length and width of 3 parts of the pancreas, namely the head, corpus and tail. Additionally, radiograms were made to obtain a projection of the gland on the vertebral column. Development of the pancreas was correlated with the age of the foetuses calculated on the basis of crown-rump (CR) length measurements. The correlation coefficient with CR was 0.998 for the pancreas length, 0.709 for the width of the head, 0.703 for the width of the corpus and 0.712 for the width of tail. Gender dimorphism was not found (p > 0.05) with regard to the morphometry of the pancreas. In the material under examination the pancreas did not change its position in relation to the vertebral column. The head projected on the vertebral column in the range Th(12)-L(2) (most frequently L(1)-L(2)), the corpus on Th(12)-L(2) and the tail on Th(11).

The pancreaticoduodenal arteries in human foetal development.

Knowledge of the course of the pancreaticoduodenal arteries is of great importance in pancreatic surgery. Lack of care in the preparation of these vessels may lead to ischaemia or necrosis of the duodenum, the first loop of the jejunum, the head of the pancreas and even the liver, bile ducts and transverse colon. In such events, the surgeon would need to diagnose the course of the vessels and their anastomoses intraoperatively. Anatomical dissection in this special area diminishes the risk of early complications in the form of bleeding and late complications in the form of narrowing of the anastomoses, fistulas, necrosis and intestinal ileus after surgical resection or drainage. The aim of the present study was to determine the variability of the pancreaticoduodenal arteries in human foetuses. The material examined consisted of 60 human foetuses of both sexes (33 male, 27 female) from spontaneous abortion or stillbirth and ranging in age from the 16th to 38th week of prenatal life. White latex solution to of volume between 15 ml and 30 ml was injected into the thoracic aorta. The results of this were that a typical pancreatic supply from the coeliac trunk and superior mesenteric artery was observed in all cases. The coeliac trunk, splenic artery and gastroduodenal artery also appeared invariably. However, variability was observed in further generations of branches. The gastroduodenal artery with its branches, the anterior and posterior pancreaticoduodenal arteries, was constantly present. Irrespective of the sex of the foetus, in 10% of cases a large vessel was observed which ran horizontally on the anterior surface of the pancreas from head to tail and which originated in the anterior superior pancreaticoduodenal artery. We termed this vessel the "anterior pancreatic artery". In all cases there were anterior and posterior pancreaticoduodenal arcades, but in two cases (3.3%) a double anterior pancreaticoduodenal arcade was observed.

The internal thoracic artery in human foetuses.

The aim of this study was to examine the internal thoracic artery (ITA) in human foetuses. The research material consisted of 32 human foetuses (18 female, 14 male) from the 21(st) to 24(th) week of intrauterine life. After intravascular injection with white latex LBS 3060, the foetuses were fixed in 10% neutral formalin solution. The whole course of the ITA was prepared. Photographic documentation was performed with a Nikon Coolpix 4500 digital camera, and source pictures of arteries were rendered in a Digital Computer System Analysis. The ITA was evaluated with regard to its origin, length, distance from the edge of the sternum to two intercostal spaces (2(nd), 5(th)) and division into terminal branches. The right ITA (RITA) arose from the ascending (68.7%), arcuate (21.9%) and descending (3.2%) parts of the subclavian artery. In other cases (6.2%) it was a branch of the thyrocervical trunk. The left ITA (LITA) was a branch of the ascending (78.1%) and arcuate (21.9%) parts of the subclavian artery. The ITA was longer in male foetuses. Regardless of sex, the LITA was longer than the RITA. Coefficient correlation between the RITA and LITA was 0.92 (p < 0.001). The distance of the ITA from the edge of sternum in the 2(nd) and 5(th) intercostal spaces on both sides was greater in females. It appeared most frequently in the 6(th) space (43.7% right-sided and 56.3% left-sided). Typical bifurcation of the ITA into the superior epigastric artery and the musculophrenic artery was observed in 78.1% of cases on the right side and in 81.25% of cases on the left side.

Variability of the azygos vein system in human foetuses.

The aim of the study was to examine the variability of the azygos vein system and to determine the location of the veins with reference to the vertebral midline and the skeletopy of their termination. The research material consisted of 32 human foetuses (14 male, 18 female) from 21(st) to 24(th) week of intrauterine life, fixed in 10% neutral formalin solution. Conventional anatomical - radiographic methods were used. 5 different configurations of the azygos vein system were found. In the 1(st) configuration there were 3 azygos veins, with both the left side veins, the hemiazygos vein (HV) and the hemiazygos accessory vein (HAV), joining the azygos vein (AV) separately. In the 2(nd) configuration the HV and the HAV were joined to the AV together. In the 3(rd )configuration the HAV was missing, and the 4(th) to 8(th) left intercostal veins were joined to the AV separately. In the 4(th) configuration the HV was missing. In the 5(th) configuration there was the AV only, which coursed along the vertebral midline. In these 4 configurations (1-4) the AV was located on the right side (90.6%) and in the 5(th) configuration the AV was located in the vertebral midline. The termination of the AV projected mostly on Th(4) (81.25%). The junction of the HV and the AV was found the most frequently at Th(8) (35.7%), and the junction of the HAV and AV most frequently at Th(4) (41.6%).