Variations in the vascular supply of pancreas and transverse colon: a case report / Variaciones en el suministro vascular de páncreas y colon transverso: reporte de un caso

During anatomical dissection of the abdominal cavity of an adult male corpse, a changing pattern of vascular supply of pancreas and of the transverse colon was observed. The inferior pancreatic artery and the middle colic artery arose from a common trunk of the superior mesenteric artery. Moreover, the lienal artery did not direct a dorsal branch to the neck of the pancreas, but rather sent two greater pancreatic arteries (proximal and distal) to the body of the gland and one caudal artery to the terminal portion of the pancreas. We also observed a large communicating branch between the proximal portion of the middle colic artery and the ascending branch of the left colic artery, previously described as artery of Moskowitz. Based on these data, clinical and surgical implications of these variations were highlighted.

Durante la disección anatómica de la cavidad abdominal del cadáver de un hombre adulto, se observó un patrón cambiante en el suministro vascular del páncreas y del colon transverso. La arteria pancreática inferior y la arteria cólica media surgían de un tronco común desde la arteria mesentérica superior. Además, la arteria esplénica no daba origen a la rama dorsal hasta el cuello del páncreas, más bien contaba con dos arterias pancreáticas mayores (una proximal y una distal) hasta la glándula, y una arteria caudal. También se observó una conexión entre la parte proximal de la arteria cólica media y el ramo ascendente de la arteria cólica izquierda lo que fue previamente definido como la arteria de «Moskowitz¼. Las implicaciones quirúrgicas de estas variaciones fueron destacadas en base a estos datos.

Complex distribution of renal vessels

The retroperitoneal lumbar vessels should be immediately recognized during urological, vascular and radiologicalmedical procedures. Few studies have tried to define an exact pattern for the lumbar vasculature andmost of the anatomical descriptions suggest the presence of a regular pattern. Nevertheless, for the renal bloodvessels, despite the described regular pattern, several anatomical variations have interested anatomists for morethan a century. Taking into account that there is a constant need for reviewing this anatomy due to the advancesin surgical and/or uroradiological procedures techniques, we describe a complex variation of the renalblood vessels found during the dissection routine in our laboratory. A male cadaver, aged 65 years, embalmedwith 10% formalin solution presented, on the left side, two renal arteries arising from the abdominal aorta,both of them entering the kidney on the hilar region. From the hilar region of the left kidney, there were alsotwo tributary renal veins, which join together 3.0 cm from the hilus, before draining into the inferior venacava. These two tributary veins were large in diameter, and made a loop around the two renal arteries and alsothe ureter. No anatomical variations were found on the right side. This is a complex anatomical variation of therenal vessels which might have functional implications once the venous loop described might be a compressionfactor for the renal arteries and for the ureter.

Tortuosity of the internal carotid artery cervicalcourse: case reports and literature review

Variations in the course of the internal carotid arteries (ICA) are reported in the literature as coiling, looping,kinking or tortuosities of the vessels. Nevertheless, the definitions between these variants are confusing. Also, the clinical relevance of morphological anomalies of extracranial ICA is a matter of debate because of up to date the natural history of kinking, coiling and tortuosities of this artery is not well known. However, some authors consider that these conditions are burdened with disabling, even fatal neurological complications.Also, variations of the ICA cervical course may lead to direct contact of the artery with the pharyngeal wall, being of great clinical relevance due to the large number of routine procedures performed in this region. In the present study, we describe two cases of ICA tortuosities and review the current literature regarding the causes, symptoms and clinical significances of the variations of the cervical ICA course. Tortuosity of the cervical ICA is not a rare condition and they can easily be mistaken clinically for an aneurysm, a tumor or an abscess and subsequently injured during an attempted biopsy or excision. Thus, regardless the controversy of its causes (congenital or acquired) it should be included in the differential diagnosis of cervical soft tissue widening. Also, they should be taken into consideration on the diagnostic procedures for ischemic transitory attacks and/or stroke.

The arterial supply of the nodus sinuatrialis in bovine Gir

A irrigaçäo da área do nó sinoatrial foi estudada em 50 coraçöes de fêmeas de bovinos da raça Gir, após injeçäo das artérias coronárias com Neoprene-látex. A área nodal, com muita frequência (72 por cento dos casos) foi irrigada pela a. coronária esquerda, sendo 58 por cento pelo ramus circumflexus sinister e 14 por cento por outros ramos. O r. proximalis atrii sinistri irrigava a área nodal isoladamente (42 por cento) ou associado com o r. intermedius atrii dextri (2 por cento) ou com r. distalis dexter (2 por cento) ou com um colateral do r. ventricularis dexter (2 por cento). Numerosas anastomoses foram encontradas entre os ramos que irrigavam a área nodal. Pela primeira vez foi descrito, em coraçöes de bovinos, ramos átrio-ventriculares das artérias coronárias

Análise crítica da importância clínica e cirúrgica das variaçöes da origem da artéria do nó sinoatrial do coraçäo humano / Critical analysis of the clinical and surgical importance of the variations of the origin of the sinoatrial node artery of the human heart

Várias säo as controvérsias clínicas decorrentes das discrepâncias em relaçäo às descriçöes e relaçöes (quanto a sexo e grupo racial) das artérias coronárias do coraçäo humano. Objetivo. Estudar a importância clínica e cirúrgica das variaçöes de origem de artéria do nó sinoatrial do coraçäo humano. Método. Foram estudados 100 coraçöes (31 de cadáveres do sexo feminino e 69 do masculino; 24 caucasianos (brancos) e 36 näo-caucasianos (negros e multatos), cuja idade variou de 7 a 80 anos. Os coraçöes, considerados como normais, tivera, suas artérias injetadas com gelatina misturada com substância radiopaca (Cylatrast) e com um pigmento de cor vermelha (cinábrio ou sulfeto de mercúrio) ou de cor azul (azul da Prússia). Resultados e Conclusöes. 1) A artéria do nó sinoatrial originou-se, na maioria das vezes, da artéria coronária direita (58 por cento); 2) quando se originou da artéria coronária esquerda, a artéria do nó sinoatrial o fez como um ramo da artéria circunflexa em 30 por cento dos casos e do tronco da artéria em 12 por cento deles; 3) as variaçöes anatômicas näo guardaram relaçäo ocm o sexo e grupo racial; 4) as artérias que mais freqüentemente originaram a artéria do nóo sinoatrial de outras artérias e nem de ambas as coronárias; 6) a distribuiçäo das artérias cironárias permite compreender a possível etiologia isquêmica da síndrome do nó sinusal doente e permite ao cirurgiäo abordar com segurança as afecçöes cardíacas

[Critical analysis of the clinical and surgical importance of the variations in the origin of the sinoatrial node artery of the human heart]. / Análise crítica da importância clínica e cirúrgica das variações da origem da artéria do nó sinoatrial do coração humano.

There are several clinical controversies derived from the discrepancy on the description and relations of the coronary arteries in human hearts of either sex and in different races. OBJECTIVE--To study the clinical and surgical importance of the variations of the origin of the artery of the sinoatrial node in hearts of human individuals. MATERIAL AND METHOD--Normal hearts of cadavers of 100 individuals (31 females and 69 males), belonging to 24 Caucasians (whites) and 36 non-Caucasians (Negroes and Mulattoes), whose age varied ranged from 7 to 80 years, were studied. The coronary arteries were injected with gelatin mixed to a radiopaque substance (Cylatrast) and a red or blue pigment. RESULTS AND CONCLUSIONS--1) The artery of the sinoatrial node was originated more frequently from the right coronary artery (58%) than from the left. 2) When originated from the left coronary artery the artery of the sinoatrial node was more frequently a branch of the circumflex artery (30%) than from the trunk of the artery (12%). 3) No sexual or racial factor influenced the anatomical variations. 4) The most frequent arteries originating the artery of the sinoatrial node were the right anterior medial atrial artery and the left anterior medial atrial artery. 5) No cases of blood supply to the sinoatrial node were found originating neither from other arteries than the coronary arteries nor from both coronary arteries. 6) The distribution of the coronary arteries allows to understand the possible ischemic etiology of the sinusal node syndrome and permits to the surgeon a safe approach to cardiac disease.