A Case of Multiple Posterior Intercostal Artery Common Trunks in Conjunction with Additional Arterial Variations

Several thoracic vasculature variations were observed in an 81-year-old male cadaver during routine dissection. These included 5 common trunks of posterior intercostal arteries, a descending branch of the right vertebral artery, and atypical neurovascular relationships within intercostal spaces. On the right side, two common trunks of posterior intercostal arteries were observed supplying the 4th-7th intercostal spaces and 9th-11th intercostal spaces, respectively. There was also a small accessary branch supplying the 9th intercostal space. The first three posterior intercostal spaces on the right were supplied by a descending branch of the vertebral artery. On the left side, three common trunks of posterior intercostal arteries were encountered, supplying intercostal spaces 3-5, 6-7, and 11 plus the subcostal space. An atypical neurovascular relationship was observed in the right 6th intercostal space, as well as the left 2nd, 3rd, and 6th intercostal spaces. This is the first case report that presents 5 common trunks of posterior intercostal arteries, as well as common trunks in conjunction with other arterial variation in the posterior thoracic wall. These variations carry a high level of clinical significance and may be helpful in guiding decision-making related to surgical procedures related to the posterior thoracic cavity and spine.

Extraordinary first jejunal arterial variation associated with annular pancreas undergoing pancreaticoduodenectomy for pancreatic cancer: a case report

Purpose Annular pancreas encountered in adults and jejunal arterial variations are rare. Anatomical variations can cause conflicts between oncology and surgical safety. Methods Case report of a 68-year-old man suffering from vomiting because of an annular pancreas and a ductal adenocarcinoma of the pancreas head invading the second portion of the duodenum. Results Contrast-enhanced computed tomography showed multiple arterial variations describing the absence of the coeliac trunk such that the left gastric artery (LGA), splenic artery and superior mesenteric artery (SMA) were arising separately from the aorta. The accessory left hepatic artery arose from the LGA; and both the common hepatic artery and combined trunk of the replaced right hepatic artery with the higher replaced first jejunal artery separately arose close to the root of the SMA. The patient underwent curative pancreaticoduodenectomy which achieved 3 years of recurrence-free survival. Conclusion This was an extraordinary case of annular pancreas with first jejunal arterial variation detailing an embryological interpretation as well as considerations for balancing short- and long-term outcomes.

THE CYSTIC ARTERY: AN OBSERVATIONAL STUDY AND CLINICAL SIGNIFICANCE OF ITS VARIANTS

Background: Cystic artery variations are frequent and important for invasive as well as invasive procedure around the hepatibiliary area. Variation can be in term of origin, course and termination of CA. Aim: Aim was to identify new type of Cystic arterial variation in term of origin, no. of CA, and termination and surgical implications of these variations. Materials and methods: Study was carried out at department of anatomy, S.M.S Medical college and hospitals Jaipur (Raj). Total 60 cadaver were included in the study. Ethical clearance was taken for the same. Subjects with history of abdominal surgery around Hepatobiliary area were excluded. Result: Source of origin of SCA was RHA (majority of cases), Aberrant RHA, SMA, HAP. DCA was observed in 13.34% cases. Accessory CA arose from RHA, ARHA, HAP, PSPD. Compound DCA was observed in 5% cases. Longer CA was observed in the study. Conclusion: Variation related to CA are essential to keep in mind while dealing with Hepatobiliary area during invasive and non invasive procedures as well. KEY WORDS: Cystic, Hepatobiliary, Cystic arterial variation.

Arterial Variation: Higher Bifurcation of the Brachial Artery into Radial and Ulnar Arteries in the Arm of a Male Corpse

The objective of this study was to describe a morphological variation of the bifurcation of the brachial artery, which was located at a higher level in the right arm of a male corpse. This variation was found during a dissection process performed at the anatomy laboratory of the Centro Universitário de Volta Redonda, in the state of Rio de Janeiro, Brazil, by graduates in medicine during a course of dissection conducted by the Academic League of Human Anatomy of the institution. The brachial artery was located medial in the arm, as usual, but its bifurcation into the radial and ulnar arteries happened prematurely, midway down the diaphysis. The morphological variation has previously been described by other authors; its occurrence is not well established yet, since there are articles that say it is common, and others that say it is rare. The implication of this morphological variation in medical practice is related to the measure of blood pressure in the arm; this higher bifurcation of the brachial artery can be confusing for the health provider measuring the blood pressure of a patient. This article describes a morphological variation and hopes to help to elucidate its patterns.

Continuation of perforating branch of fibular artery as dorsalis pedis artery

For the effective management of vascular surgeries such as arterial cannulation, bypass surgery, percutaneous trans arterial catheterization etc. needs a sound knowledge of the vessels of the lower extremity, their branching pattern, course followed by them and their diameter. The knowledge of arterial variation is a must before a surgeon deals with the concerned area. We are reporting a case in which the perforating branch of fibular artery passes through the gap in the interosseous membrane and continues as the dorsalis pedis artery. Normally anterior tibial artery, a branch of popliteal artery is the main artery of the extensor compartment of the lower limb which continues on the dorsum of foot as dorsalis pedis artery but in this case, it became hypoplastic and disappeared below, proximal to the ankle joint.

Superficial Ulnar Artery Crossing Over the Palmaris Longus Tendon at the Wrist in a Cadaver: A Case Report

Superficial ulnar artery (SUA) is defined as arterial variation of an ulnar artery of high origin that lies superficially in the forearm. Because an SUA may be mistaken for a superficial vein, there is a risk of arterial damage. During routine dissection of the cadaver, we incidentally detected a case of unilateral SUA in the left arm. SUA arose from the axillary artery and descended superficial to the axillary artery and median nerve. At the wrist, the SUA crossed over palmaris longus (PL) tendon from the radial side to the ulnar side. In this cadaver, the PL tendon was located on the ulnar side and was thicker than the flexor carpi radialis tendon. Clinicians should check for the presence of SUA before any technical procedure, because lack of awareness of its presence can have serious consequences.