A Corrosion Cast Study of Ramification Pattern of Portal Vein in Right Lobe of Human Liver.

Objectives: The aim of the study was to know the intrahepatic ramification pattern of portal vein in right lobe of liver & its variations. Methods: 25 human fresh livers were obtained after autopsy and studied by corrosion cast method. Polymeric granules of butyl butyrate were dissolved in acetone and 20% homogenous solution was made. Solution was injected into portal vein and the injected liver was placed in 10 %formal saline for 24 hours at room temperature (20°C) for polymerization of infused butyl butyrate solution. Maceration of liver tissue achieved by wholeorgan immersion in 1.8 N KOH solution at 68°C for 24 hrs. Each cast thus obtained was preserved in glycerin and details were studied. Results: The length of the right portal vein varies 0.5 to 1.8 cm (1.2 cm). The right portal vein bifurcated into second order branches - right anterior portal vein (RAPV) & right posterior portal vein (RPPV) in 87 % of the cases, while trifurcated in rest of 13 % of cases. The angle between the anterior and posterior division ranged from 58°-95 °. Anterio-superior (P8) branch shown three type of ramification - Bifurcation type (72 %), P8- one pedicle type (8 %) and P8- trifurcation type (20%). Anterio-inferior (P5max ) branch shown the three type of ramification pattern - P5 -common type (72 %), P5 – P8 anterior type (28 %) but P5 – P8 posterior type was not observed. Right Posterior Portal Vein has shown three types of ramification pattern - Type I-Fan shaped (64%),Type II (28 %) & Type III-Trifurcation type (8%). Conclusions: The findings of present study on hepatic vasculature have immense importance in the field of hepato-biliary surgeries like hepatic resection, segmentectomy and liver transplantation.

An unusual presentation of an intra-parenchymatous frontal yolk sac tumour : case report.

Yolk sac tumours are rare conditions among the germ cell tumours. Intracerebral germ cell tumours are exceedingly rare. A 15 year old girl presenting with a one week history of raised intracranial pressure is described. She had bilateral papilloedema and a right 6th nerve palsy. CT scan showed an intra-parenchymatous right frontal ring enhancing lesion of 2 cms diameter. The patient underwent microsurgical total excision of the tumour, followed by chemotherapy. She was asymptomatic at three years following surgery.

Solitary skull metastasis from mucoepidermoid mimicking a parotid tumour.

Metastatic parotid tumours in the skull are very rare. An interesting case of a mucoepidermoid parotid tumour metastasizing to the skull vault is described in a patient who had previously been operated for a pituitary adenoma 20 years back with no post operative radiotherapy; however, she required hormonal supplementation therapy. She underwent an operation for a parotid tumour 7 years ago and received postoperative radiotherapy for the parotid tumour away from the site of the skull metastases. No local recurrence of the parotid tumour was noted. The initial diagnosis was that of a solitary intradiploic meningioma. Interesting clinico-radiological findings are presented.

Gluteal neuralgia - unusual presentation in an adult with intrasacral meningocele: a case report and review of literature.

A nineteen year old man with intrasacral meningocele is reported, who presented with long standing episodic gluteal pain and progressive muscle wasting. Magnetic resonance imaging established the diagnosis. Surgical excision relieved the pain but muscle wasting persisted. Pertinent literature is reviewed.