Multiple variations of the hepatobiliary vasculature including a splenomesenteric trunk.

Anatomical variations of the origins and branching patterns of the hepatobiliary system may be encountered during both surgical and laparoscopic procedures. We report the rare finding of a splenomesenteric trunk with an absent coeliac trunk in a 74-year-old female cadaver. Due to the absence of the coeliac trunk, the common hepatic artery was found to originate from the splenic artery. Embryological considerations and possible clinical consequences are discussed.

A case of atypical insertion of the levator scapulae.

Anatomical variations in the musculature of the spine have the potential to cause functional and postural abnormalities, which in turn could lead to chronic myofascial and skeletal pain. We present a unilateral case of a 71-year-old Caucasian female in which the left levator scapulae muscle gave rise to an accessory head that inserted, by way of a flat aponeurotic band, to the ligamentum nuchae, the tendon of the rhomboideus major and the superior aspect of the serratus posterior superior muscle. The innervation was provided by a branch of the dorsal scapular nerve. By exerting unilateral traction on the vertebrae and surrounding musculature, this unusual variation might have resulted in clinical consequences including scoliosis and movement abnormalities of the head and neck as well as myofascial pain syndrome.

A retrotracheal right subclavian artery in association with a vertebral artery and thyroidea ima.

The retro-oesophageal right subclavian artery is an anatomical abnormality encountered by anatomists and pathologists and, more recently, interventional cardiologists and thoracic surgeons with an incidence of 0.2-2% in the population. We report a case of a retrotracheal right subclavian artery which originated distally along the left aortic arch and coursed between the trachea and the oesophagus. Additionally, the aortic arch gave rise to a common trunk, which subsequently bifurcated to yield to a right vertebral artery and a left thyroidea ima, replacing the left inferior thyroid artery. Consequently the right and the left recurrent laryngeal nerves were found to recur normally. The possible embryonic development of these branching patterns and their clinical significance is discussed.