Morphological characteristics of the left gastric, common hepatic and splenic arteries. A descriptive study in human cadaveric specimens.

OBJECTIVE: to evaluate the morphology of the branches of celiac trunk (CT), left gastric (LGA), common hepatic (CHA), and splenic (SA) arteries in cadaveric specimens from a sample of a Colombian population. METHODS: descriptive cross-sectional study of 26 blocks from the abdominal upper segment of human cadavers who underwent forensic autopsies at the Instituto de Medicina Legal at Bucaramanga, Colombia. The vascular beds of the celiac trunk were, subsequently, perfused with a semi-synthetic resin. RESULTS: the diameters of LGA, CHA, and SA were 3.6±0.8mm, 5,2±1.2mm, and 5.9±1.0mm, respectively. Statistically, LGA and SA were different (p=<0.001). SA followed a linear trajectory in 8 (31%) samples, slightly tortuous in 4 (15%), and tortuous in 14 (54%). The tortuosity index was 1.25±0.18. Of the branches of CHA, the proper hepatic artery (PHA) had 4.8±1.2mm in diameter and 18.8±9.1mm in length, whereas the gastroduodenal artery (GDdA) had 4.1±0.8mm. In 2 cases (7.7%), an accessory hepatic artery from the LGA was found to supply perfusion to the left hepatic lobe. Finally, in 2 cases (7.7%) the SA came independently from the abdominal aorta. CONCLUSION: the observed emergence incidence of the CT branches from the same level as reported in the literature is lower. The characterization, along with their variants, of LGA, CHA, and SA must be considered in surgical procedures in the upper abdominal segment, to avoid iatrogenic complications.

Morphological characteristics of the left gastric, common hepatic and splenic arteries. A descriptive study in human cadaveric specimens / Características morfológicas das artérias gástricas esquerda, hepática comum e esplênica. Um estudo descritivo em espécimes cadavéricos humanos

ABSTRACT Objective: to evaluate the morphology of the branches of celiac trunk (CT), left gastric (LGA), common hepatic (CHA), and splenic (SA) arteries in cadaveric specimens from a sample of a Colombian population. Methods: descriptive cross-sectional study of 26 blocks from the abdominal upper segment of human cadavers who underwent forensic autopsies at the Instituto de Medicina Legal at Bucaramanga, Colombia. The vascular beds of the celiac trunk were, subsequently, perfused with a semi-synthetic resin. Results: the diameters of LGA, CHA, and SA were 3.6±0.8mm, 5,2±1.2mm, and 5.9±1.0mm, respectively. Statistically, LGA and SA were different (p=<0.001). SA followed a linear trajectory in 8 (31%) samples, slightly tortuous in 4 (15%), and tortuous in 14 (54%). The tortuosity index was 1.25±0.18. Of the branches of CHA, the proper hepatic artery (PHA) had 4.8±1.2mm in diameter and 18.8±9.1mm in length, whereas the gastroduodenal artery (GDdA) had 4.1±0.8mm. In 2 cases (7.7%), an accessory hepatic artery from the LGA was found to supply perfusion to the left hepatic lobe. Finally, in 2 cases (7.7%) the SA came independently from the abdominal aorta. Conclusion: the observed emergence incidence of the CT branches from the same level as reported in the literature is lower. The characterization, along with their variants, of LGA, CHA, and SA must be considered in surgical procedures in the upper abdominal segment, to avoid iatrogenic complications.

RESUMO Objetivo: avaliar a morfologia dos ramos das artérias do tronco celíaco (CT), gástrica esquerda (LGA), hepática comum (HC) e esplênica (SA) em espécimes cadavéricos de uma amostra de uma população colombiana. Métodos: estudo transversal descritivo de 26 blocos do segmento superior abdominal de cadáveres humanos submetidos a necropsias forenses no Instituto de Medicina Legal de Bucaramanga, Colômbia. Os leitos vasculares do tronco celíaco foram, posteriormente, perfundidos com resina semissintética. Resultados: os diâmetros de LGA, CHA e SA foram 3,6±0,8mm, 5,2±1,2mm e 5,9±1,0mm, respectivamente. Estatisticamente, LGA e SA foram diferentes (p=<0,001). A SA seguiu uma trajetória linear em 8 (31%) amostras, levemente tortuosa em 4 (15%) e tortuosa em 14 (54%). O índice de tortuosidade foi de 1,25±0,18. Dos ramos do ACS, a artéria hepática própria (APH) tinha 4,8±1,2mm de diâmetro e 18,8±9,1mm de comprimento, enquanto a artéria gastroduodenal (GDdA) tinha 4,1±0,8mm. Em 2 casos (7,7%), uma artéria hepática acessória do GIG foi encontrada para fornecer perfusão ao lobo hepático esquerdo. Finalmente, em 2 casos (7,7%) a SA veio independentemente da aorta abdominal. Conclusão: a incidência observada de emergência dos ramos de TC do mesmo nível relatado na literatura é menor. A caracterização, juntamente com suas variantes, de LGA, CHA e SA deve ser considerada em procedimentos cirúrgicos no segmento abdominal superior, para evitar complicações iatrogênicas.

Morphological description and clinical implications of myocardial bridges: an anatomical study in Colombians.

BACKGROUND: Myocardial bridges represent a hotly debated research topic. Myocardial bridges are considered to be a vascular heart variation due to its intermittent or enduring reducing of the arterial lumen, with a possible ischemic effect. METHODS: 154 hearts were studied, having been extracted as fresh autopsy material. Coronary arteries were injected with synthetic resin and cleaned by extracting the pericardial fat. RESULTS: 92 myocardial bridges were observed in 62 hearts (40.3%). Average myocardial bridge length was 19.9 mm. Myocardial bridges varied per artery from one myocardial bridge in 42 hearts (27.3%), two myocardial bridges in 11 hearts (7.2%), three myocardial bridges in 8 hearts (5.2%) and four myocardial bridges in 1 heart (0.7%). Most myocardial bridges coincided with the anterior interventricular artery in its proximal and intermediate segments in 61 cases (39.6%) and left diagonal artery in 11 cases (7.2%). Arteries emitted just before myocardial bridges (pre-bridge branch) in 50 cases (54.3%) of the sample, with an average caliber of 1.41 mm. A third coronary artery was present in 46 cases (29.8%) of total sample. A higher frequency of myocardial bridges was found in hearts with a third coronary artery. CONCLUSION: It is necessary to consider the clinical importance of the variations considering the arterial distribution and associated clinical implications.

Descrição morfológica e implicações clínicas de pontes miocárdicas: um estudo anatômico em colombianos / Descripción morfológica e implicaciones clínicas de puentes miocárdicos: un estudio anatómico en colombianos / Morphological description and clinical implications of myocardial bridges: an anatomical study in colombians

FUNDAMENTO: Pontes miocárdicas representam uma fonte de discussão em pesquisa. Pontes miocárdicas são consideradas uma variação cardíaca vascular devido à sua intermitente ou repetida redução do lúmen arterial, com um possível efeito isquêmico. OBJETIVO: O objetivo do presente estudo foi determinar a incidência de pontes miocárdicas na população miscigenada da Colômbia. MÉTODOS: 154 corações foram estudados, tendo sido extraídos em autópsias. As artérias coronárias foram injetadas com resina sintética e limpas através da extração da gordura pericárdica. RESULTADOS: 92 pontes miocárdicas foram observadas em 62 corações (40,3 por cento). O comprimento médio das pontes era de 19,9 mm. As pontes miocárdicas variaram por artéria, de uma ponte em 42 corações (27,3 por cento), duas pontes em 11 corações (7,2 por cento), três pontes em oito corações (5,2 por cento) e quatro pontes em um coração (0,7 por cento). A maioria das pontes encontrava-se com a artéria interventricular esquerda em seus segmentos proximal e intermediário em 61 casos (39,6 por cento) e com a artéria diagonal esquerda em 11 casos (7,2 por cento). As artérias se exteriorizavam em porção anterior às pontes miocárdicas (segmento pré-ponte) em 50 casos (54,3 por cento) da amostra, com uma média de 1,41 mm de calibre. Terceira artéria coronária estava presente em 46 casos (29,8 por cento) do total da amostra. Uma freqüência maior de pontes miocárdicas foi encontrada em corações com terceira artéria coronária. CONCLUSÃO: É necessário considerar a importância clínica das variações, tendo em vista a distribuição arterial e as implicações clínicas relacionadas.

BACKGROUND: Myocardial bridges represent a hotly debated research topic. Myocardial bridges are considered to be a vascular heart variation due to its intermittent or enduring reducing of the arterial lumen, with a possible ischemic effect. METHODS: 154 hearts were studied, having been extracted as fresh autopsy material. Coronary arteries were injected with synthetic resin and cleaned by extracting the pericardial fat. RESULTS: 92 myocardial bridges were observed in 62 hearts (40.3 percent). Average myocardial bridge length was 19.9 mm. Myocardial bridges varied per artery from one myocardial bridge in 42 hearts (27.3 percent), two myocardial bridges in 11 hearts (7.2 percent), three myocardial bridges in 8 hearts (5.2 percent) and four myocardial bridges in 1 heart (0.7 percent). Most myocardial bridges coincided with the anterior interventricular artery in its proximal and intermediate segments in 61 cases (39.6 percent) and left diagonal artery in 11 cases (7.2 percent). Arteries emitted just before myocardial bridges (pre-bridge branch) in 50 cases (54.3 percent) of the sample, with an average caliber of 1.41 mm. A third coronary artery was present in 46 cases (29.8 percent) of total sample. A higher frequency of myocardial bridges was found in hearts with a third coronary artery. CONCLUSION: It is necessary to consider the clinical importance of the variations considering the arterial distribution and associated clinical implications.

FUNDAMENTO: Puentes miocárdicos representan una fuente de discusión en investigación. Se consideran los puentes miocárdicos una variación cardiaca vascular en virtud de su intermitente o repetida reducción del lumen arterial, con un posible efecto isquémico. OBJETIVO: El objetivo del presente estudio fue determinar la incidencia de puentes miocárdicos en la población mestiza de Colombia. MÉTODOS: Se estudiaron 154 corazones, extraídos en autopsias. Se eyectó resina sintética en las arterias coronarias y seguidamente se las limpiaron con la extracción de la grasa pericárdica. RESULTADOS: Se observaron 92 puentes miocárdicos en 62 corazones (40,3 por ciento). La longitud promedio de los puentes era de 19,9 mm. Los puentes miocárdicos variaron de acuerdo con la arteria, en la siguiente proporción: un puente en 42 corazones (27,3 por ciento), dos puentes en 11 corazones (7,2 por ciento), tres puentes en ocho corazones (5,2 por ciento) y cuatro puentes en un corazón (0,7 por ciento). La mayoría de los puentes se encontraba con la arteria interventricular izquierda en sus segmentos proximal e intermediario -en 61 casos (39,6 por ciento); en 11, el puente se mostraba con la arteria diagonal izquierda (7,2 por ciento). Las arterias se exteriorizaban en porción anterior a los puentes miocárdicos (segmento pre-puente) en 50 casos (54,3 por ciento) de la muestra, con un promedio de 1,41 mm de espesor. La tercera arteria coronaria estaba presente en 46 casos (29,8 por ciento) del total de la muestra. Se encontró una frecuencia mayor de puentes miocárdicos en corazones con tercera arteria coronaria. CONCLUSIÓN: Es necesario considerar la importancia clínica de las variaciones, teniendo en cuenta la distribución arterial y las implicaciones clínicas relacionadas.

Morphological expression of the renal artery: a direct anatomical study in a Colombian half-caste population / Expresión morfológica de la arteria renal: un estudio anatómico directo en población mestiza colombiana

Irrigation of the kidneys is usually provided by a single renal artery; however, variations on this pattern have frequently been reported. This study was aimed at establishing the renal arteries' frequency and morphological characteristics in cadaverous material taken from a half-caste population from Bucaramanga (Colombia). The sample included 195 renal blocks corresponding to 57 (14.6 percent) kidneys from females and 333 (85.4 percent) from males. The renal arteries were injected with synthetic resin (palatal GP41L); following the resin's polymerization, the renal blocks were placed in KOH solution for corrosion the renal parenchyma. The individuals from whom the renal blocks, 74.9 percent of the kidneys presented renal arteries single and 25.1 percent had additional renal arteries. Average right and left renal artery length was 34.6 mm and 28.6 respectively (p<0.001). Renal artery diameter was 4.87 mm. Main renal artery diameter in kidneys presenting additional renal arteries was less than that of those having a single renal artery, this being a significant difference (p= 0.0000). The renal arteries more frequently (85 percent) originated from the anterolateral part of the aorta. The right renal artery emerged rostrally in 49.2 percent, whilst both arteries were located at the same level in 34.4 percent. The renal poles received a greater contribution from frontal division branches, the upper pole 46.4 percent and the lower pole 55.9 percent. No significant differences were presented in the characteristics studied here regarding gender. The renal arteries presented great variability in morphological expression regarding their emergence and ramification level

La irrigación de los riñones es proporcionada usualmente por una arteria renal única; sin embargo, variaciones en este patrón han sido frecuentemente reportadas. El objetivo de este estudio fue establecer las características morfológicas y frecuencia de las arterias renales en material cadavérico de una población mestiza de Bucaramanga (Colombia). La muestra incluyó 195 riñones, correspondiendo 57 (14,6 por ciento) y 333 (85,4 por ciento) a cadáveres femeninos y masculinos respectivamente. Las arterias renales fueron inyectadas con resina sintética (palatal GP41L),luego de la polimerización de la resina, fueron sumergidos en solución de KOH, para la corrosión del parénquima renal. Los bloques renales presentaron una arteria renal única en un 74,9 por ciento, y arterias renales adicionales en un 25,1 por ciento. El largo promedio de las arterias renales derechas e izquierdas fue 34,6 mm y 28,6 mm respectivamente(p < 0,001). El diámetro renal fue de 4,87 mm. El diámetro mayor de las arterias renales adicionales fue menor que el de la arteria renal única, con una diferencia significativa (p= 0,0000). Las arterias renales se originaron con mayor frecuencia (85 por ciento) de la parte anterolateral de la aorta. La arteria renal emergió por anterior en un 49,2 por ciento, aunque ambas arterias estaban localizadas al mismo nivel en un 34,4 por ciento. Los polos renales recibieron su irrigación de las ramas de la división anterior en un 46,4 por ciento y 55,9 por ciento, en el polo superior e inferior respectivamente. No existieron diferencias significativas en las características con respecto al sexo. Las arterias renales presentan gran variabilidad en su expresión morfológica con respecto a su emergencia y nivel de ramificación