[Anatomic variations of the hepatic artery : a study of 33 cases and review]. / Variations anatomiques de l'artère hépatique et applications pratiques: a propos de 33 cas et revue de la littérature.

BACKGROUND: The hepatic artery is prone to numerous anatomic variations dictated by certain variables of the organogenesis. Aim : To research study the anatomic variations of the hepatic artery as well as their implications within surgical practice. METHODS: Study of a post-mortem series of 33 cases of dissection of the hepatic pedicle with fresh corpses (deaths amounting no longer than 24 hours), carried out in conditions that are quite close to those met with the living ones. RESULTS: The common hepatic artery was divided at the foot of the hepatic pedicle into a gastro duodenal artery and into a proper hepatic artery in 94% of the cases. In 6% of the cases, we noticed a three level change, a branching of the average hepatic artery into a gastro duodenal artery, a right hepatic artery and a left hepatic artery. The proper hepatic artery represented the pedicle segment of the hepatic artery in 94% of the cases. In 36% of the cases, the liver was irrigated by two hepatic arteries. In 12% of the cases, there was the matter of the right hepatic artery, branch of the mesenteric artery. In 24% of the cases, there was the matter of the left hepatic artery branch of the left gastric artery. CONCLUSION: The perfect knowledge in preoperative and preoperative stages of the anatomic variations of the hepatic pedicle is quite essential. Actually, the lack of knowledge of these variations exposes to the risk of certain complications which are sometimes deadly during hepatic transplants, pancreatic surgery, cholecystectomies, through laroscopic way as well as in the treatment of gastro-esophagus surging.

[Abscess of obturator internal muscle]. / Abces du muscle obturateur interne:a propos d'un cas.

The abscess of obturator internal muscle is a rare disorder. The literature states only sporadic cases. Because of its rarity, the diagnosis is often late. Indeed, the presence of functional disability of the lower limb associated to a made septic syndrome evoke in the first of all, arthritis of the hip. We bring back (report) an observation illustrating the difficulties and the delay diagnosis of an abscess of the obturator internal muscle. It is about a ten year old girl having consulted for a septic syndrome with functional disability of the hip. The patient having been treated (handled) at the beginning for a cold of the hip. Secondarily she was operated for septic arthritis of the hip. The surgical investigation showed it self negative. It is only to the pelvien scanner realized after ten days of hospitalization that the diagnostic of abscess was reserved. The evolution has been favourable after surgical drainage and antibiotherapie.