RESUMEN
Aneurysms of the abdominal aorta are only sporadically documented in the veterinary literature. This publication describes 2 canine cases in which abdominal aortic malformation was detected by sonography and confirmed by computed tomography. In one case a histological diagnosis of an aortic aneurysm was possible.One dog showed posterior weakness, in the second dog the aortic aneurysm had been noticed sonographically during a routine examination.In the patient with the proven aortic aneurysm, it may be presumed that a hemodynamically relevant component in consequence to the altered flow profile and occurring turbulence exists. In accordance with human medical standards, regular monitoring of these patients, both clinically and by ultrasound, would therefore appear to be useful in order to be able to detect the occurrence or progression of secondary hemodynamic changes and possible thrombus formation at an early stage. In contrast, the second case presented here has not shown any clinical signs with regard to the abdominal vascular malformation up to the present time.
Asunto(s)
Aorta Abdominal , Aneurisma de la Aorta Abdominal , Enfermedades de los Perros , Animales , Perros , Aorta Abdominal/anomalías , Aorta Abdominal/diagnóstico por imagen , Aneurisma de la Aorta Abdominal/veterinaria , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Aneurisma de la Aorta Abdominal/diagnóstico , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/diagnóstico por imagen , Enfermedades de los Perros/congénito , Tomografía Computarizada por Rayos X/veterinaria , Ultrasonografía/veterinariaRESUMEN
Here, we describe an interesting case of a patient with the duplication of inferior vena cava, high-positioned bifurcation of the abdominal aorta with transposition of iliac arteries, and right renal aplasia associated with end-stage renal disease who underwent kidney transplant. In this case, the patient with anorectal malformations with a vaginal fistula was prepared and underwent a kidney transplant. During the surgery, we discovered duplicated inferior vena cava and transposed iliac arteries. After the surgery, computed tomography angiography revealed the inferior vena cava duplication with the 2 connections between the right and left inferior vena cava with the formation of an anomalous circle, high-positioned bifurcation of the abdominal aorta at the level of the L2 vertebral body, and transposition of right and left iliac arteries. Also, we observed the right kidney aplasia and absence of blood circulation in the left native kidney. In our case, a delayed diagnosis of pyelonephritis resulted in the progression to end-stage renal disease that necessitated a kidney transplant, during which we found these anomalies. We confirmed the asymptomatic course of these anomalies, diagnosed only during radiological imaging or surgical intervention. Patients with congenital anomalies of the kidney and urinary tract should undergo complete investigations before surgical decisions. Diagnosis of this pathology in the preoperative period, especially in transplant patients, will alert the surgery team in advance of the operation and allow preparation for the intraoperative difficulties that are typically associated with anomalies such as inferior vena cava transposition or aplasia.
Asunto(s)
Aorta Abdominal , Fallo Renal Crónico , Trasplante de Riñón , Malformaciones Vasculares , Vena Cava Inferior , Humanos , Vena Cava Inferior/anomalías , Vena Cava Inferior/diagnóstico por imagen , Vena Cava Inferior/cirugía , Femenino , Fallo Renal Crónico/cirugía , Fallo Renal Crónico/etiología , Fallo Renal Crónico/diagnóstico , Resultado del Tratamiento , Aorta Abdominal/anomalías , Aorta Abdominal/cirugía , Aorta Abdominal/diagnóstico por imagen , Malformaciones Vasculares/cirugía , Malformaciones Vasculares/complicaciones , Malformaciones Vasculares/diagnóstico por imagen , Aortografía , Angiografía por Tomografía Computarizada , Anomalías Múltiples/cirugía , Flebografía/métodos , Hallazgos Incidentales , Arteria Ilíaca/cirugía , Arteria Ilíaca/anomalías , Arteria Ilíaca/diagnóstico por imagen , Adulto , Pielonefritis/cirugía , Pielonefritis/etiología , Pielonefritis/diagnóstico , Pielonefritis/diagnóstico por imagen , Valor Predictivo de las PruebasRESUMEN
PURPOSE: Direct connection between the celiac trunk (CT) and inferior mesenteric artery (IMA) is very rare, knowledge of this anomaly is of great importance to surgeons and anatomists. INTRODUCTION: Splanchnic arteries arise from the abdominal aorta (AA). Unusual development of these arteries can lead to considerable variations. Historically there were a lot of classification of the variation in the CT and IMA, none of the classifications describes a direct connection from IMA to CT. MATERIALS AND METHODS: We report a rare case in which the connection between the CT and AA was lost and replaced by a direct anastomosis with IMA. RESULTS: 60 year old male presented to the hospital to undergo a computed tomography scan. Which showed that there was no CT arising from the AA, but there was a large anastomosis arises from the IMA and ended with a short axis and Left gastric artery (LGA), Splenic artery (SA), Common hepatic artery (CHA) arise from this axis, these arteries continued to the stomach and spleen and liver normally. The anastomosis provides the total supply to the CT. The CT branches are normal. CONCLUSION: Knowledge of the arterial anomalies provides an important help in clinical surgical implications especially in organs transplant.
Asunto(s)
Aorta Abdominal , Arteria Mesentérica Inferior , Masculino , Humanos , Persona de Mediana Edad , Aorta Abdominal/diagnóstico por imagen , Aorta Abdominal/cirugía , Aorta Abdominal/anomalías , Arteria Mesentérica Inferior/diagnóstico por imagen , Arteria Mesentérica Inferior/cirugía , Arteria Celíaca/diagnóstico por imagen , Arteria Celíaca/anomalías , Arteria Hepática/anomalías , Anastomosis QuirúrgicaRESUMEN
OBJECTIVES: Abdominal aortic coarctation and hypoplasia are uncommon diseases, recognized most often in pediatric-aged individuals. Comprehensive studies regarding the pathologic spectrum of these aortopathies are nonexistent. This investigation was undertaken to better define the histologic and morphologic character of abdominal aortic narrowings affecting children and assess its potential relevance to contemporary clinical practice. METHODS: Aortic specimens obtained during open operations in children being treated for symptomatic, noninflammatory abdominal aortic narrowings at the University of Michigan were subjected to histologic study after hematoxylin and eosin, Movat, Verhoeff Van Gieson, and Masson's trichrome preparations. Microscopic findings were correlated with the anatomic aortic images. In addition, a detailed review was completed of all prior reports in the English literature that included images depicting the histologic character of noninflammatory abdominal aortic narrowings in children. RESULTS: Among a series of 67 pediatric-aged individuals undergoing open surgical interventions for abdominal aortic narrowings, eight children ranging in age from 9 months to 18 years, had adequate aortic tissue available for study. The loci of the specimens paralleled the anatomic sites of segmental coarctations observed in the entire series, with involvement of the suprarenal abdominal aorta (n = 3), intrarenal aorta (n = 2), and infrarenal aorta (n = 1). Diffusely hypoplastic abdominal aortas (n = 2) included one case of a de facto aortic duplication, represented by a channel that paralleled the narrow native aorta and gave origin to celiac artery branches, as well as the superior mesenteric and renal arteries. Concentric or eccentric intimal fibroplasia was observed in every aorta, often with internal elastic fragmentation and duplication (n = 4). Media abnormalities included elastic tissue disorganization (n = 3) and focal medial fibrosis (n = 1). Organizing luminal thrombus occurred in two infants. Coexistent ostial stenoses of the celiac, superior mesenteric, or renal arteries were observed in all but the only child who had an infrarenal aortic coarctation. Neurofibromatosis type 1 affected one child whose histologic findings were indistinguishable from those of the other children. A review of prior published histologic images of abdominal aortic coarctation and hypoplasia affecting children from other centers revealed a total of 14 separate reports, each limited to single case photomicrographs, of which 11 exhibited intimal fibroplasia. CONCLUSIONS: Intimal fibroplasia is a common accompaniment of developmental abdominal aortic coarctation and hypoplasia. It is posited that intimal fibroplasia, which is likely progressive in instances of abnormal shear stresses in these diminutive vessels, may contribute to less salutary outcomes after endovascular and certain open reconstructions of pediatric abdominal aortic narrowings.
Asunto(s)
Aorta Abdominal , Coartación Aórtica , Adolescente , Aorta Abdominal/anomalías , Aorta Abdominal/patología , Aorta Abdominal/cirugía , Coartación Aórtica/patología , Coartación Aórtica/cirugía , Niño , Preescolar , Humanos , Lactante , Procedimientos de Cirugía PlásticaAsunto(s)
Humanos , Femenino , Adulto , Hemoptisis/etiología , Pulmón , Arterias , Aorta Abdominal/anomalíasRESUMEN
Online supplemental material is available for this article.
Asunto(s)
Aorta Abdominal/anomalías , Arteria Ilíaca/anomalías , Aorta Abdominal/diagnóstico por imagen , Angiografía por Tomografía Computarizada/métodos , Humanos , Arteria Ilíaca/diagnóstico por imagen , Imagenología Tridimensional/métodos , Masculino , Persona de Mediana Edad , Ultrasonografía/métodosRESUMEN
Online supplemental material is available for this article.
Asunto(s)
Aorta Abdominal/anomalías , Aorta Abdominal/diagnóstico por imagen , Circulación Colateral/fisiología , Angiografía por Tomografía Computarizada/métodos , Anciano , Femenino , HumanosAsunto(s)
Aorta Abdominal/anomalías , Aortitis/diagnóstico , Infecciones por Salmonella/diagnóstico , Sepsis/diagnóstico , Anciano , Aorta Abdominal/diagnóstico por imagen , Aortitis/complicaciones , Servicio de Urgencia en Hospital/organización & administración , Fiebre/etiología , Humanos , Hiperglucemia/etiología , Masculino , Polipéptido alfa Relacionado con Calcitonina/análisis , Polipéptido alfa Relacionado con Calcitonina/sangre , Sepsis/complicaciones , Tomografía Computarizada por Rayos X/métodosRESUMEN
Abstract We describe a case of unusual development of the celiac trunk observed in the cadaver of 1-year old male child. The celiac trunk branched into five vessels: the splenic, common hepatic and left gastric arteries, the left inferior diaphragmatic artery, and a short trunk that branched into the right inferior diaphragmatic artery and right accessory hepatic artery. Additionally, the manner of branching of the vessel was unusual: it was possible to distinguish two branching points that corresponded to its s-shaped trajectory. There were also other variations of vascular supply, such as the presence of a left accessory hepatic artery, an additional superior pancreatoduodenal artery, and others. It should be noted that multiple developmental variations can be common in clinical practice and clinicians should be aware of them during diagnostic and interventional procedures.
Resumo Apresentamos um relato de caso de desenvolvimento incomum do tronco celíaco em um cadáver do sexo masculino de 1 ano de idade. O tronco celíaco ramificou-se para cinco vasos: as artérias esplênica, hepática comum e gástrica esquerda, a artéria diafragmática inferior esquerda e um tronco pequeno que se ramificou para a artéria diafragmática inferior direita e para a artéria hepática direita acessória. Além disso, a forma como o vaso se ramificou foi incomum: é possível distinguir dois pontos de ramificação que correspondem à trajetória em formato de S. Também houve outras variações do suprimento vascular, como a presença da artéria hepática esquerda acessória, da artéria pancreaticoduodenal superior acessória e outras. Cabe observar que a variação de desenvolvimento múltipla pode ser comum na prática clínica, e os médicos devem estar cientes dela durante os procedimentos de diagnóstico e intervenção.
Asunto(s)
Humanos , Masculino , Lactante , Aorta Abdominal/anatomía & histología , Arteria Esplénica/anatomía & histología , Artería Gástrica/anatomía & histología , Arteria Hepática/anatomía & histología , Aorta Abdominal/anomalías , Arteria Esplénica/anomalías , Artería Gástrica/anomalías , Arteria Hepática/anomalíasRESUMEN
Retroperitoneal hematoma formation following elective open abdominal aortic aneurysm (AAA) repair may be occult. We report a case of recurrent hypotensive episodes in the postanesthesia care unit (PACU) that were temporarily treated successfully with fluid, blood products, and vasopressors. At reoperation, active bleeding was excluded; however, upon reopening the bovine pericardial patch closure of the retroperitoneum, hematoma between the aneurysmal sac and inferior vena cava (IVC) had caused IVC compression. Evacuation of the hematoma rapidly restored venous return and hemodynamics. This report describes a case of retroperitoneal hematoma formation and highlights challenges associated with diagnosing bleeding in this compartment.
Asunto(s)
Aneurisma de la Aorta Abdominal/complicaciones , Procedimientos Quirúrgicos Electivos/efectos adversos , Hematoma/etiología , Espacio Retroperitoneal/patología , Cuidados Posteriores , Anciano , Aorta Abdominal/anomalías , Aorta Abdominal/patología , Aneurisma de la Aorta Abdominal/cirugía , Hematoma/cirugía , Humanos , Hipotensión/diagnóstico , Hipotensión/etiología , Masculino , Resultado del Tratamiento , Vena Cava Inferior/fisiopatologíaRESUMEN
BACKGROUND: Renovascular hypertension (RVH) associated with renal artery and abdominal aortic narrowings is the third most common cause of pediatric hypertension. Untreated children may experience major cardiopulmonary complications, stroke, renal failure, and death. The impetus of this study was to describe the increasingly complex surgical practice for such patients with an emphasis on anatomic phenotype and contemporary outcomes after surgical management as a means of identifying those factors responsible for persistent or recurrent hypertension necessitating reoperation. METHODS: A retrospective analysis was performed of consecutive pediatric patients with RVH undergoing open surgical procedures at the University of Michigan from 1991 to 2017. Anatomic phenotype and patient risk factors were analyzed to predict outcomes of blood pressure control and the need for secondary operations using ordered and binomial logistic multinomial regression models, respectively. RESULTS: There were 169 children (76 girls, 93 boys) who underwent primary index operations at a median age of 8.3 years; 31 children (18%) had neurofibromatosis type 1, 76 (45%) had abdominal aortic coarctations, and 28 (17%) had a single functioning kidney. Before treatment at the University of Michigan, 51 children experienced failed previous open operations (15) or endovascular interventions (36) for RVH at other institutions. Primary surgical interventions (342) included main renal artery (136) and segmental renal artery (10) aortic reimplantation, renal artery bypass (55), segmental renal artery embolization (10), renal artery patch angioplasty (8), resection with reanastomosis (4), and partial or total nephrectomy (25). Non-renal artery procedures included patch aortoplasty (32), aortoaortic bypass (32), and splanchnic arterial revascularization (30). Nine patients required reoperation in the early postoperative period. During a mean follow-up of 49 months, secondary interventions were required in 35 children (21%), including both open surgical (37) and endovascular (14) interventions. Remedial intervention to preserve primary renal artery patency or a nephrectomy if such was impossible was required in 22 children (13%). The remaining secondary procedures were performed to treat previously untreated disease that became clinically evident during follow-up. Age at operation and abdominal aortic coarctation were independent predictors for reoperation. The overall experience revealed hypertension to be cured in 74 children (44%), improved in 78 (46%), and unchanged in 17 (10%). Children undergoing remedial operations were less likely (33%) to be cured of hypertension. There was no perioperative death or renal insufficiency requiring dialysis after either primary or secondary interventions. CONCLUSIONS: Contemporary surgical treatment of pediatric RVH provides a sustainable overall benefit to 90% of children. Interventions in the very young (<3 years) and concurrent abdominal aortic coarctation increase the likelihood of reoperation. Patients undergoing remedial surgery after earlier operative failures are less likely to be cured of hypertension. Judicious postoperative surveillance is imperative in children surgically treated for RVH.
Asunto(s)
Aorta Abdominal/cirugía , Coartación Aórtica/cirugía , Presión Sanguínea , Hipertensión Renovascular/cirugía , Obstrucción de la Arteria Renal/cirugía , Procedimientos Quirúrgicos Vasculares , Adolescente , Factores de Edad , Antihipertensivos/uso terapéutico , Aorta Abdominal/anomalías , Aorta Abdominal/diagnóstico por imagen , Aorta Abdominal/fisiopatología , Coartación Aórtica/complicaciones , Coartación Aórtica/diagnóstico por imagen , Coartación Aórtica/fisiopatología , Niño , Preescolar , Femenino , Humanos , Hipertensión Renovascular/diagnóstico , Hipertensión Renovascular/etiología , Hipertensión Renovascular/fisiopatología , Masculino , Obstrucción de la Arteria Renal/complicaciones , Obstrucción de la Arteria Renal/diagnóstico por imagen , Obstrucción de la Arteria Renal/fisiopatología , Estudios Retrospectivos , Resultado del Tratamiento , Procedimientos Quirúrgicos Vasculares/efectos adversosRESUMEN
INTRODUCTION: Heterotopic vascular calcification is a common complication of maintenance hemodialysis (MHD) patients. Galectin 3 (Gal-3) has been reported to be associated with cardiovascular calcification. The current study aims to explore the potential predictive value of serum Gal-3 for severe abdominal aortic calcification (AAC) and AAC progression in MHD patients. METHODS: A prospective cohort who underwent hemodialysis during July 2014 at the Blood Purification Center of Ruijin Hospital were followed up for 3 years. Two AAC assessments were performed: one at baseline and one after the 3-year follow-up period. Serum Gal-3 was detected with quantitative ELISA kits. SPSS 23.0 and MedCalc 11.4.2.0 were used to analyze the data. FINDINGS: One hundred and fifty-two patients were recruited. Approximately 59.9% were male, the median age was 60 (50-67) years. Logistic regression analysis indicated that serum Gal-3 was an independent risk factor for both follow-up severe AAC and AAC progression. Receiver operating characteristic (ROC) curve analysis revealed significant prognostic value of serum Gal-3 for predicting severe AAC and AAC progression within 3 years. DISCUSSION: We found serum Gal-3 is correlated to vascular calcification in ESRD patients. Gal-3 may be a potential biomarker of vascular calcification for MHD patients.
Asunto(s)
Aorta Abdominal/anomalías , Biomarcadores/sangre , Galectina 3/sangre , Diálisis Renal/métodos , Calcificación Vascular/sangre , Anciano , Proteínas Sanguíneas , Estudios de Cohortes , Femenino , Galectinas , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Factores de Riesgo , Calcificación Vascular/etiologíaAsunto(s)
Aorta Abdominal/anomalías , Trisomía/genética , Venas Umbilicales/anomalías , Fístula Vascular/genética , Aborto Eugénico , Cromosomas Humanos Par 17/genética , Femenino , Humanos , Ilustración Médica , Mosaicismo/embriología , Embarazo , Trisomía/diagnóstico , Fístula Vascular/diagnóstico , Fístula Vascular/embriología , Adulto JovenRESUMEN
BACKGROUND: Although patients with various types of heritable aortopathy often require distal aortic repair, data are limited regarding the most extensive operations-open thoracoabdominal aortic aneurysm (TAAA) repairs. The objective of this multicenter registry study was to characterize TAAA repairs in a large cohort of patients with different heritable aortic diseases. METHODS: From the 3699 patients enrolled at 8 participating centers in the Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions (GenTAC) Registry, we identified 155 open TAAA repairs in 142 unique patients. We examined data related to clinical characteristics, surgical techniques, and outcomes. RESULTS: The primary diagnoses included Marfan syndrome (n = 76; 54%), familial thoracic aortic aneurysm and dissections (n = 31; 22%), and Loeys-Dietz syndrome (n = 10; 7%). Most repairs were performed for aneurysms associated with aortic dissection (n = 110; 71%). The most common repairs involved the entire descending thoracic aorta with distal extension (21% Crawford extent I and 36% extent II). Adjuncts used during repair varied substantially. The operative mortality rate was 1.3%. Other complications included paraplegia (4%), acute renal failure (5%), and vocal cord paralysis (21%). Reoperation after TAAA repair was required in a subset of cases for early bleeding (n = 15; 10%) and late repair failure (n = 7; 5%). CONCLUSIONS: Open TAAA repairs are necessary in a variety of heritable aortic diseases. These patients often require extensive surgical repair, and a variety of adjunctive techniques are utilized. The risk of repair failure and the need for reoperation in a subset of patients support the need for vigilant long-term surveillance after repair.
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Aorta Abdominal/cirugía , Aorta Torácica/cirugía , Enfermedades de la Aorta/cirugía , Sistema de Registros , Procedimientos Quirúrgicos Vasculares/métodos , Adulto , Aorta Abdominal/anomalías , Aorta Torácica/anomalías , Enfermedades de la Aorta/genética , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Complicaciones Posoperatorias/mortalidad , Estudios Retrospectivos , Tasa de Supervivencia/tendencias , Resultado del Tratamiento , Estados Unidos/epidemiologíaRESUMEN
Computed tomography is increasingly used as a treatment planning method in canine patients with diseases of the retroperitoneum, however, published information on normal variations in the caudal vena cava (CVC) are currently lacking. The objectives of this retrospective descriptive study were to characterize CVC variants using CT angiography in a sample of small breed dogs and localize the CVC bifurcations for each variant. Inclusion criteria were small breed dogs (weight ≤ 15) that underwent contrast-enhanced CT scans of the CVC, abdominal aorta, and CVC tributaries. A total of 121 small breed dogs were sampled. Four right-sided and one left-sided CVC variations were identified: normal (88/121, 72.7%), caudal-partial split (17/121, 14.0%), partial duplication (8/121, 6.6%), complete duplication (7/121, 5.8%), and left-sidedness (1/121, 0.8%). The mean lumbar vertebral levels of the CVC bifurcation were L6.39 ± 0.41, L5.70 ± 0.35, L4.39 ± 0.42, L2.74 ± 0.38, and L6.4 in the normal, caudal-partial split, partial duplication, complete duplication, and left-sidedness types, respectively. The location of the CVC bifurcation, the relationship between the aortic trifurcation and the CVC bifurcation, and the location of the bilateral deep circumflex iliac veins with respect to the CVC bifurcation were significantly different among the right-sided types (P ≤ .001). Bilateral deep circumflex iliac veins joined to the ipsilateral common iliac veins and the CVC in the caudal-partial split and duplication types, respectively. The results of this study indicated that canine CVC variants may be frequent and should be considered during surgery or diagnostic imaging of the retroperitoneum.
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Aorta Abdominal/anomalías , Enfermedades de los Perros/diagnóstico por imagen , Enfermedades Vasculares/veterinaria , Vena Cava Inferior/anomalías , Animales , Aorta Abdominal/diagnóstico por imagen , Perros , Femenino , Masculino , Linaje , Estudios Retrospectivos , Tomografía Computarizada por Rayos X/veterinaria , Enfermedades Vasculares/diagnóstico por imagen , Vena Cava Inferior/diagnóstico por imagenRESUMEN
Pulmonary sequestrations (PS) are typically supplied by a vessel originating from thoracic aorta, or abdominal aorta. Differences in imaging features between these PS subtypes have not been described.To analyze the imaging features of PS with arterial supply from the thoracic and abdominal aorta.Retrospectively, 23 pathologically proven cases of pulmonary sequestration were analyzed and compared based on the site of feeding artery origin.In 21 cases (21/23), the PS was soft tissue density. 1â(1/23) PS was purely cystic and another heterogeneous with both cystic and solid components (1/23). In 16/23 cases, the feeding vessel(s) arose from the thoracic aorta (male:female ratio 1:7) and in 7/23 cases from the abdominal aorta (male:female ratio 4:3). Feeding vessels from the thoracic aorta were duplicated in 7/16 cases. PS location (Pâ<.05) and size (Pâ<.001) differed based on the origin of the feeding vessel (thoracic aorta: 14/16 left lower lobe, mean volume 962.97âmL; abdominal aorta: 3/7 left lower lobe, mean volume 1120.89âmL). The feeding arteries themselves differed in size depending on their site of origin (thoracic aorta: mean diameter 7.0mmâ±â2.7âmm, mean length 44.6mmâ±â10.9âmm; abdominal aorta: mean diameter 3.3mmâ±â0.6âmm, mean length 103.6mmâ±â34.5âmm).PS size and distribution differ depending upon the site of feeding vessel origin as does the size of the feeding vessel itself.
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Aorta Abdominal/anomalías , Aorta Torácica/anomalías , Secuestro Broncopulmonar/diagnóstico , Angiografía por Tomografía Computarizada/métodos , Pulmón/irrigación sanguínea , Tomografía Computarizada Multidetector/métodos , Adolescente , Adulto , Aorta Abdominal/diagnóstico por imagen , Aorta Torácica/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Estudios Retrospectivos , Adulto JovenRESUMEN
The celiac trunk is one of the main sources of vascularization of the supracolic abdominal compartment. It arises from the abdominal aorta, at the level of T12-L1 vertebrae and classically branches into the splenic artery, common hepatic artery, and left gastric artery. We report here an atypical branching pattern of the celiac trunk, found during the dissection of a 60-year-old female's formalin-fixed cadaver. The atypically celiac trunk gave rise to four branches: a common trunk for left and right inferior phrenic arteries, an accessory left gastric artery, the common hepatic artery, and a splenogastric trunk. Knowledge in detail about normal anatomy and variation in the branching pattern of the celiac trunk is important in surgical, oncological, and radiological interventional procedures and must be taken into account to avoid possible complications.
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Variación Anatómica , Arteria Celíaca/anomalías , Aorta Abdominal/anomalías , Cadáver , Disección , Femenino , Artería Gástrica/anomalías , Arteria Hepática/anomalías , Humanos , Persona de Mediana Edad , Arteria Esplénica/anomalíasRESUMEN
Anatomic variations involving arterial supply of the large intestines are of clinical significance. Variations range from the pattern of origin, branching and territorial supply. The colon, the part of the large intestine, usually receives its arterial blood supply from branches of the superior and inferior mesenteric arteries. However, anatomic variation in this vascular arrangement has been reported, with vascular anatomy of the right colon being described as complex and more variable compared with the left colon. During routine cadaveric dissection of the supracolic and infracolic viscera, we encountered an additional mesenteric artery originating directly from the anterior surface of the abdominal aorta between the origins of the superior and inferior mesenteric arteries. This additional "inferior mesenteric artery" ran obliquely superiorly toward the left colon giving rise to two branches supplying the distal part of the ascending colon, the transverse colon and the proximal part of the descending colon. Awareness and knowledge of this anatomic variation are important for radiologists and surgeons to improve the quality of surgery and avoid both intra- and postoperative complications during surgical procedures of the colon.
Asunto(s)
Variación Anatómica , Colon/irrigación sanguínea , Arteria Mesentérica Inferior/anomalías , Arteria Mesentérica Superior/anomalías , Anciano de 80 o más Años , Aorta Abdominal/anomalías , Cadáver , Colon/cirugía , Femenino , Humanos , Complicaciones Intraoperatorias/etiología , Complicaciones Intraoperatorias/prevención & control , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & controlRESUMEN
Background and objectives: Ischemia-reperfusion (IR) caused by infrarenal abdominal aorta cross-clamping is an important factor in the development of ischemia-reperfusion injury in various distant organs. Materials and Methods: We investigated potential antioxidant/anti-inflammatory effects of thymosin beta 4 (Tß4) in a rat model of abdominal aortic surgery-induced IR. Tß4 (10 mg/kg, intravenous (i.v.)) was administered to rats with IR (90-min ischemia, 180-min reperfusion) at two different periods. One group received Tß4 1 h before ischemia, and the other received 15 min before the reperfusion period. Results: Results were compared to control and non-Tß4-treated rats with IR. Serum, bronchoalveolar lavage fluid and lung tissue levels of oxidant parameters were higher, while antioxidant levels were lower in the IR group compared to control. IR also increased inflammatory cytokine levels. Tß4 reverted these parameters in both Tß4-treated groups compared to the untreated IR group. Conclusions: Since there is no statistical difference between the prescribed results of both Tß4-treated groups, our study demonstrates that Tß4 reduced lung oxidative stress and inflammation following IR and prevented lung tissue injury regardless of timing of administration.