Abnormal bilateral drainage of testicular veins: embryological aspects and surgical application.

A combination of unusual bilateral drainage of the testicular veins observed in a male cadaver utilized for educational and research purposes is prescribed. In specific, the right testicular vein was terminated on the right renal vein at almost right angle, whereas the left testicular vein was bifurcated into a lateral component drained into the left renal vein and a medial component opened into the inferior vena cava close to its confluence with the left renal vein. Such a co-existence of bilateral testicular vein termination is very rarely presented in the literature. The main goal of this study is to provide an embryological development model for these variants and to highlight the likely occurrence of these anomalies to the surgeon of the region. The awareness of these venous anomalies can facilitate the surgeons in order to ligate properly and adequately the abnormal venous terminations and collaterals reducing that way the recurrence rate of varicocele.

Accessory internal thoracic artery and its clinical significance.

The accessory internal thoracic artery is a relatively large branch of the initial part of the internal thoracic artery, which was found in 4.54% of 22 cadavers studied in the Institute of Anatomy of the Medical School of Aristotle University of Thessaloniki. The course of this artery lies usually in the inner surface of the anterolateral thoracic wall and its diameter is sometimes almost equivalent to that of the main trunk of the internal thoracic artery. We think, that the knowledge of this arterial branch is essential for the thoracic surgeon during the preparation of the internal thoracic artery for coronary revascularization as well as for the surgeon during the placement of thoracic drainage for pneumothorax. Furthermore, it has to be kept in mind for the interpretation of angiographies of the subclavian artery.

Cannieu-Riche anastomosis of the ulnar to median nerve in the hand: case report.

We observed in a male cadaver the presence of a new type of very long Cannieu-Riche anastomosis between the proximal portion of the deep branch of the ulnar nerve for the adductor pollicis and ramus of the recurrent branch of the median nerve to the superficial head of the flexor pollicis brevis. The clinical relevance of such a communication is the possible preservation of the function of all or part of thenar muscles from the ulnar nerve in case of median nerve lesion. The ignorance of that anomaly can induce obscure clinical, surgical and electroneuromyographical findings. We report on the incidence, the double innervation and the clinical significance of Cannieu-Riche anastomosis and provide a new classification of the various types of this nerval connection.

Variability in superior hypogastric plexus morphology and its clinical applications: a cadaveric study.

BACKGROUND: The superior hypogastric plexus (SHP) that is formed anterior to the aorta and the sacral promontory and is located anterior to the L5-S1 vertebrae, normally continues as the inferior hypogastric plexus. Several variations have been described from a single trunk to a plexiform arrangement. MATERIALS AND METHODS: The SHP was dissected in 35 formalized cadavers. RESULTS: A single thin and rounded nerve was found in 17.14% of subjects. The type of a wide reticular formation was observed in 28.57% of specimens. Interestingly, a band-like nerve trunk consisting of nerve bundles connected with loose connective tissue was evident in 22.85% of cadavers. Eventually, two distinct nerves at a short distance with each other were found in 31.44% of subjects. Furthermore, we found that branches of the major and minor splanchnic nerves contributed to SHP constitution. We provided, additionally, the topographic anatomy of the SHP with regard to the sacral promontory and the abdomen midline. CONCLUSION: A detailed knowledge of the course, the morphology, the various forms and the topography of the SHP is of outmost significance for several clinical specialties.