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At least 703 records · Page 39Linked to original sources
PubMed1998

[Intraoperative routine cholangiography in laparoscopic cholecystectomy].

In the present study of 1000 patients undergoing laparoscopic cholecystectomy we report the results of intraoperative routine cholangiography (IOC). IOC was feasible in 89.2% of the patients and presented a complete depiction of the extrahepatic bile system in 98.1%. Anatomic variations of the bile system which subsequently affected the operative management were found in 12.6% by IOC. In conclusion we recommend that using IOC anatomic variations of the bile system can be visualised and therefore accidental injuries avoided.

Adolescent↗
PubMedDate not supplied

Study of the infrapatellar nerve.

During operations on the knee, such as open meniscectomy and pes anserinus transplant for chronic anteromedial rotatory instability of the knee, the infrapatellar nerve may easily be damaged or severed. Knowledge of the normal anatomical variations of this nerve is thus of importance to the surgeon, so that he can avoid postoperative distress caused by unintentional injury to the infrapatellar nerve. Anatomical variations of this nerve have been studied in 20 cadavers, with particular reference to its relationship to the sartorius and the nerve's distance from the medial femoral epicondyle. In 52.9% of the cadavers studied, the anatomy of the infrapatellar nerve was identical on both sides. Four types of nerve were found and classified according to their relationship to the sartorius: posterior, penetrating, parallel, and anterior. The commonest type was the posterior (62.2%), where the nerve emerged at the posterior border of the sartorius before passing superficial to it to supply the skin and fascia over the front and medial aspect of the knee and the proximal part of the leg. Situated furthest from the medial femoral epicondyle was the parallel type (average, 105.7 mm), which runs parallel to the posterior border of the sartorius before crossing it at infrapatellar level.

Humans↗
PubMed2003

A rare variation in the high division of the sciatic nerve surrounding the superior gemellus muscle.

The sciatic nerve normally leaves the pelvis by passing through the greater sciatic foramen below piriformis. However, it may divide into its common fibular and tibial nerve components within the pelvis and its relationship with piriformis is variable. In this paper, we describe a new anatomical variation in which the common fibular nerve passed superior, and the tibial nerve inferior, to the superior gemellus muscle. Anatomical variations such as these may contribute to piriformis syndrome, coccygodynia and muscle atrophy.

Humans↗
PubMed2002

Persistent median artery in the carpal tunnel: color Doppler ultrasonographic findings.

OBJECTIVE: To describe the ultrasonographic and color Doppler ultrasonographic findings in 2 patients with carpal tunnel syndrome associated with a persistent median artery and to report the frequency of this anatomic variation in healthy volunteers. METHODS: Two patients with the clinical appearance of carpal tunnel syndrome and 100 wrists and distal forearms of 50 asymptomatic volunteers were examined with ultrasonography and color Doppler ultrasonography. The frequency and size of a persistent median artery and its relationship to median nerve anatomy in the carpal tunnel were evaluated. RESULTS: A large persistent median artery of 3 mm in diameter was found in the affected hands in both patients with carpal tunnel syndrome. Findings were confirmed at surgery. Among the asymptomatic volunteers, a persistent median artery could be found in 13 (26%, 10 [20%] unilateral and 3 [6%] bilateral), with a mean diameter of 1.1 mm (range, 0.5-1.7 mm). In 10 (63%) of 16 hands, the persistent median artery was associated with high division of the median nerve or a bifid nerve configuration in the carpal tunnel. CONCLUSIONS: A persistent median artery is a common condition in healthy individuals and in most cases is related to median nerve variations such as high division or a bifid nerve. Because a persistent median artery has a superficial course close to the transverse carpal ligament, preoperative diagnosis of this anatomic variation may be of clinical importance.

Adult↗
PubMed2000

[A resected case of lung cancer with an extrapericardial single trunk formed by the left pulmonary veins].

We successfully performed left lower lobectomy in a lung cancer patient with anatomical variation in which left superior and inferior pulmonary veins were connected to the left atrium after foaming an extrapericardial single trunk. When indicating lobectomy, confirming the presence of such anatomical variation is clinically significant to prevent the development of pulmonary edema in the residual lung due to improper division of the single trunk as well as preventing subsequent possibly essential completion pneumonectomy.

Aged↗
PubMed1988

Anatomical and computed tomographic studies of the pancreatic tail.

The location of the pancreatic tail in the lienorenal ligament and its relationship to the splenic hilus were studied in 32 computed tomography (CT) scannings and in 37 autopsy specimens. We found several anatomical variations in both study groups: the pancreatic tail did not penetrate the lienorenal ligament in 24% of the autopsy specimens and in 37.5% of the CT group. The tail was adjacent to the splenic hilus in 29.7% of the autopsies and in 25% of the CT group. We classified the anatomical variations into 4 categories, three of which could be well demonstrated on CT with satisfactory correlation to the anatomical findings of the autopsy specimens.

Cadaver↗
PubMed1987

The basilar artery bifurcation: microscopical anatomy.

An anatomical study is performed with the acid of the operating microscope of the basilar artery bifurcation and the posterior portion of the Circle of Willis. The anatomical variations of the superior cerebellar arteries, the P 1 segment of the posterior cerebral arteries and the posterior portion of the posterior communicating arteries are described as well as the anatomical variations of the small branches originating from these arteries: the arteriae interpedunculares profundae, the arteriae thalamo perforantes and the arteriae chorioideae posteriores.

Basilar Artery↗
PubMed2002

Recognition of a non-recurrent laryngeal nerve during carotid endarterectomy.

Cranial nerve injury during carotid endarterectomy (CEA), while infrequent, may have serious consequences. The recurrent laryngeal nerve is one of the most commonly injured cranial nerves. Fortunately, most of these injuries are temporary. Anatomic variations in the position of cranial nerves present challenges to surgeons during CEA. Although the occurrence of a non-recurrent laryngeal nerve (NRLN) is rare, proper recognition of this anatomic variation is critical in order to minimize complications. We present a case in which a NRLN was discovered intraoperatively and carefully preserved.

Aged↗
PubMed1994

Loculated fluid collections in hepatic fissures and recesses: CT appearance and potential pitfalls.

The peritoneum invaginates into the liver parenchyma normally, as a normal anatomic variation, or pathologically and then fissures and furrows are formed. There are four normal fissures: fissures for the ligamentum teres, ligamentum venosum, and gallbladder and the transverse fissure. Fissures caused by normal anatomic variations include accessory fissures and furrows created by diaphragmatic indentation. Pathologic fissures occur secondary to traumatic or iatrogenic causes or as a result of liver cirrhosis. When ascites, hemoperitoneum, or infected ascites is loculated in the fissures or recesses, it may be mistaken for a liver cyst, intrahepatic hematoma, or liver abscess. When peritoneally disseminated tumor cells are implanted into these spaces, they may mimic intrahepatic focal lesions. Because the clinical consequences for these entities are very different, exact localization of the lesions may be crucial in the diagnosis and management of the lesions. Complete understanding of the liver surface anatomy and awareness of these situations may prevent a misdiagnosis of a focal intrahepatic abnormality.

Humans↗
PubMed2002

Meniscofemoral ligaments revisited. Anatomical study, age correlation and clinical implications.

The meniscofemoral ligaments were studied in 84 fresh-frozen knees from 49 cadavers. Combined anterior and posterior approaches were used to identify the ligaments. In total, 78 specimens (93%) contained at least one meniscofemoral ligament. The anterior meniscofemoral ligament (aMFL) was present in 62 specimens (74%), and the posterior meniscofemoral ligament (pMFL) in 58 (69%). The 42 specimens (50%) in which both ligaments were present were from a significantly younger population than that with one MFL or none (p < 0.05). Several anatomical variations were identified, including oblique fibres of the posterior cruciate ligament (PCL), which were seen in 16 specimens (19%). These were termed the 'false pMFL'. The high incidence of MFLs and their anatomical variations should be borne in mind during arthroscopic and radiological examination of the PCL. It is important to recognise the oblique fibres of the PCL on MRI in order to avoid wrongly identifying them as either a pMFL or a tear of the lateral meniscus. The increased incidence of MFLs in younger donors suggests that they degenerate with age.

Adolescent↗
PubMed2000

Significance of acute multiple brain infarction on diffusion-weighted imaging.

BACKGROUND AND PURPOSE: Diffusion-weighted imaging (DWI) is superior to conventional MRI in identification of small new ischemic lesions and discrimination of recent infarcts from old ones. Thus, this technique is useful in the detection of acute multiple brain infarcts (AMBI). We sought to determine the frequency and the topographical and etiologic patterns of AMBI detected on DWI. METHODS: We studied 329 consecutive ischemic stroke patients who underwent DWI and MRI/MR angiography within 4 days of stroke onset. AMBI was defined as noncontiguous high signal intensities on DWI in >1 vascular territory. Stroke mechanism was determined according to the criteria of the Trial of Org 10172 in Acute Stroke Treatment (TOAST). RESULTS: We detected AMBI in 95 patients (28.9%). AMBI in anterior circulation was found in 62 cases: in 1 hemisphere in 42 (group A) and in bilateral hemispheres in 20 (group B). Twenty-two patients had AMBI in the posterior circulation (group C) and 11 in both anterior and posterior circulations (group D). The most frequent cause of stroke was large-artery atherosclerosis in groups A (33/42), B (9/20), and C (15/22) (P=0.02) and cardioembolism in group D (6/11) (P=0.02). Elevated fibrinogen or hematocrit was significantly associated with group B (P=0.01). In 9 patients in groups B and D, anatomic variations of anterior or posterior cerebral arteries or patent posterior communicating artery contributed to AMBI. CONCLUSIONS: Different topographical patterns of AMBI are associated with different vascular pathologies and stroke mechanisms. Hemorheologic abnormality or vascular anatomic variations may be contributing factors in the pathogenesis of AMBI in bilateral cerebral hemispheres or in both anterior and posterior circulations.

Acute Disease↗
PubMed1970

Atypical deep peroneal neuropathy in presence of accessory deep peroneal nerve.

The clinical and electrophysiological findings in two patients with a deep peroneal neuropathy occurring in the presence of significant innervation of the extensor digitorum brevis muscle by the accessory deep peroneal nerve are reported. This nerve is a branch of the superficial peroneal nerve which was not involved in either cases reported. An awareness of this anatomical variation of innervation of the extensor digitorum brevis muscle is important for the correct clinical and electromyographic evaluations of deep peroneal nerve lesions. The electromyographic findings in this situation are sufficiently characteristic to identify clearly this anatomical variant. From a clinical point of view, residual function in the lateral portion of the extensor digitorum brevis muscle, in the face of an otherwise complete deep peroneal palsy, should suggest this anatomical variation.

Adult↗
PubMed2005

Surgical experience in splitting donor liver into left lateral and right extended lobes.

AIM: To outline the surgical experience with donor liver splitting in split liver transplantation. METHODS: From March 1 to September 1 in 2004, 10 donor livers were split ex situ into a left lateral lobe (segments II and III) and a right extended lobe (segments I, IV-VIII) in Medical School of Hannover, and thereafter split liver transplantation was performed successfully in 19 cases. The average age, weight and ICU staying period of the donors were 32.7 years (15-51 years), 64.5 kg (45-75 kg) and 2.4 d (1-8 d) respectively. RESULTS: The average weight of the whole graft and the left lateral lobe was 1,322.6 g (956-1,665 g) and 281.8 g (198-373 g) respectively, and the average ratio of left lateral lobe to the whole graft was 0.215 (0.178-0.274). The average graft to recipient weight ratio (GRWR) of the left lateral lobe and the right extended lobe reached 2.44% (1.22-5.41%) and 1.73% (1.31-2.30%) respectively. On average it took approximately 105 min (85-135 min) to split the donor liver. Five donor organs showed anatomic variation including the left hepatic vein variation in two cases, the left hepatic artery variation in two cases and the bile duct variation in one case. CONCLUSION: Split liver transplantation has become a mature surgical technique to expand the donor pool with promising results. In the process of graft splitting, close attention needs to be paid to potential anatomic variations, especially to variations of the left hepatic vein, the left hepatic artery, and the bile duct.

Adolescent↗
PubMed1975

Major variations in anatomical origin of the coronary arteries: angiographic observations in 4,250 patients without associated congenital heart disease.

In 51 (1.2%) of 4,250 patients studied by selective coronary arteriography, one or more major elements of the coronary arterial system originated from the sinuses of Valsalva in an ectopic manner. The majority of variations involved the left coronary artery. The majority of ectopic ostia were located in the right sinus of Valsalva. Failure to recognize variations in coronary arterial origin can prolong arteriography procedures and lead to errors in interpretation of coronary artery anatomy and pathology. It is concluded from this experience that the incidence and location of major variations in coronary arterial origin are relatively predictable. The data are useful in expeding coronary arteriography procedures and thus improving patient care.

Angiocardiography↗
PubMed2006

Pulsatile tinnitus: treatment with clonazepam and propranolol.

Pulsatile tinnitus synchronous with heartbeat is rare and normally has vascular origin: arterial (malformation, arterial anatomical variation) or venous (aberrant jugular bulb, glomus tumors, tympanic glomus tumor). Early etiology identification is essential for appropriate treatment to be established. Magnetic angioresonance makes the vascular identification possible and precise. We report a case of arterial anatomical variation in which the treatment was propranolol and clonazepam, showing tinnitus improvement.

Adrenergic beta-Antagonists↗
PubMed2004

Bifurcate origin of the long head of the biceps tendon.

This report illustrates an anatomic variation of the tendon of the long head of the biceps brachii muscle. A bifurcate tendon origin attaching separately onto the supraglenoid tubercle and the posterosuperior capsulolabral tissue is described. The clinical histories and arthroscopic identification of this anatomic finding observed in 2 patients are reviewed. Recognition of the described anatomic variant at arthroscopy can aid the shoulder surgeon in focusing treatment on the actual pathology and not on aberrant anatomy. Several other anatomic variations in the origin of the long head of the biceps brachii have been previously described. The role of a bifurcate biceps tendon origin in the function of the shoulder is unclear.

Adult↗