MyMedR

Fulltext A strange case of double annular pancreas

Nayak S, Pamidi N, George BM, Guru A

JOP, 2013 Jan;14(1):96-8.

PMID: 23306345 DOI: 10.6092/1590-8577/1281

The pancreas is a soft lobulated gland situated transversely across the upper part of the posterior abdominal wall. Its parts include the head, neck, body and tail. Annular pancreas is a rare condition where the head of the pancreas surrounds the second part of the duodenum like a ring.

Matched MeSH terms: Arteries/abnormalities

Fulltext Multiple variations of the right renal vessels

Nayak BS

Singapore Med J, 2008 Jun;49(6):e153-5.

PMID: 18581008

Multiple variations of the right renal and testicular vessels were found during routine dissection in a 65-year-old male cadaver. The cadaver was healthy and did not have any other anomalies. The variations found were: presence of three right renal arteries, origin of the right inferior suprarenal artery from the middle right renal artery, two right renal veins, origin of the right testicular artery from the inferior right renal artery and the termination of the right testicular vein into the right renal vein. A sound knowledge of vascular variations in relation to the right kidney and right suprarenal gland is important in kidney transplantation and suprarenal surgery.

Matched MeSH terms: Arteries/abnormalities

Common celiaco-mesenterico-phrenic trunk and renal vascular variations

Nayak S

Saudi Med J, 2006 Dec;27(12):1894-6.

PMID: 17143371

The knowledge of vascular variations like other anatomical variations, is important during the operative, diagnostic, and endovascular procedures in abdomen. This report describes multiple variations in the upper abdominal vessels as found during the routine dissection in a 60-year-old male cadaver. The variations found were; presence of a celiaco-mesenterico-phrenic trunk, a common inferior phrenic trunk, 2 right renal arteries originating from abdominal aorta, 2 suprarenal arteries originating from the lower right renal artery, 3 right renal veins opening separately into inferior vena cava, and termination of right testicular vein into the lowest vein among the 3 right renal veins. The existence of a celiaco-mesenterico-phrenic trunk has not been reported yet. Although, other variations reported in this case exist as individual variations, a concomitant variation of them has not been reported yet. The knowledge of such variations is quite useful in planning any upper abdominal surgery.

Matched MeSH terms: Mesenteric Arteries/abnormalities*

Multiple arterial, neural and muscular variations in upper limb of a single cadaver

Vollala VR, Nagabhooshana S, Bhat SM, Potu BK, Rodrigues V, Pamidi N

Rom J Morphol Embryol, 2009;50(1):129-35.

PMID: 19221659

During routine dissection classes to undergraduate medical students, we have observed some important anatomic variations in the right upper limb of a 45-year-old cadaver. The anomalies were superficial ulnar artery, persistent median artery, variant superficial palmar arch, third head for biceps brachii, accessory head for flexor pollicis longus, variant insertion of pectoralis major, absence of musculocutaneous nerve, coracobrachialis muscle supplied by lateral root of median nerve and anomalous branching of median nerve in arm and forearm. Although there are individual reports about these variations, the combination of these variations in one cadaver has not previously been described in the literature consulted. Awareness of these variations is necessary to avoid complications during radiodiagnostic procedures or surgeries in the upper limb.

Matched MeSH terms: Arteries/abnormalities*

Dieulafoy's lesion of the rectum

Gul YA, Jabbar MF, Karim FA, Moissinac K

Acta Chir. Belg., 2002 Jun;102(3):199-200.

PMID: 12136541

Dieulafoy's lesion is an uncommon cause of gastrointestinal haemorrhage. It may present with massive and life threatening bleed and although more common in the upper gastrointestinal tract, it is being increasingly reported as affecting the lower gastrointestinal tract. Diagnosis is usually achieved during proctoscopic and endoscopic visualization. In cases where there is profuse and torrential hemorrhage, angiography may help to confirm the diagnosis. There are a few treatment options available, all of which have a varying degree of success. More commonly than not, a combination of treatment is warranted as illustrated by our case. Recurrent bleeding may occur just as in cases of Dieulafoy's lesion affecting the upper gastrointestinal tract. Even though endoscopic visualization of the lower gastrointestinal tract in the presence of profuse lower gastrointestinal haemorrhage may not be possible, this important procedure should not be omitted as the bleeding source may be lying in a low and accessible location for prompt interventional haemorrhage control.

Matched MeSH terms: Arteries/abnormalities

Fulltext Spinal dural arteriovenous malformation: a cause of myelopathy

Ng WK, Samad SA, Tan CT

Med J Malaysia, 1996 Mar;51(1):151-3.

PMID: 10967999

Spinal vascular malformation is an uncommon but potentially treatable cause of myelopathy. We describe two cases of angiographically proven spinal vascular malformation in Malaysia. The first case is a 47-year-old man who had a progressive myelopathy and the second a 60-year-old man with intermittent attacks of transient paraparesis leading to paraplegia. As the clinical presentation of spinal vascular malformation is variable, it should be considered as a cause of patients with myelopathy.

Matched MeSH terms: Arteries/abnormalities

Fulltext Bilateral persistent sciatic arteries with unilateral complicating aneurysm

Aziz ME, Yusof NR, Abdullah MS, Yusof AH, Yusof MI

Singapore Med J, 2005 Aug;46(8):426-8.

PMID: 16049615

Persistent sciatic artery is a very uncommon embryological vascular variant. This case report highlights this rare vascular anomaly, diagnostic difficulty, complication and subsequent treatment in a 43-year-old man who presented with sudden onset of right leg pain for a few hours. He was unable to walk because of pain and numbness. Emergency right lower limb angiogram showed a large aneurysm that was initially thought to arise from the right common femoral artery, associated with thrombus formation within the right popliteal artery. A below knee amputation was performed due to worsening ischaemia of the right leg. The persistent right sciatic artery was later obliterated using percutaneous stenting and endovascular grafting, with deployment of two wallstents.

Matched MeSH terms: Arteries/abnormalities

Calibre persistent submucosal artery of the jejunum: a rare cause of massive gastrointestinal bleeding

Wan Muhaizan WM, Julia MJ, Al Amin D

Malays J Pathol, 2002 Dec;24(2):113-6.

PMID: 12887171

Historically a calibre persistent submucosal artery was most often described in the stomach. However in later years it was also discovered in the duodenum and jejunum. It is an uncommon and important cause of massive gastrointestinal bleeding in which failure of detection and early intervention would lead to death. In this paper we report a 27-year-old man with no significant medical history who presented at the emergency unit for recurrent melaena, haematochezia and hypotension. Initial investigations failed to localize the source of bleeding. Emergency exploratory laporatomy revealed a small jejunal mucosal nodule that was actively spurting blood. Histopathological evaluation identified a calibre persistent submucosal artery.

Matched MeSH terms: Arteries/abnormalities*

Deficient dorsalis pedis flow in severe idiopathic clubfeet: Does Ponseti casting affect the outcome?

Munajat I, Yoysefi M, Nik Mahdi NM

Foot (Edinb), 2017 Aug;32:30-34.

PMID: 28672132 DOI: 10.1016/j.foot.2017.05.003

BACKGROUND: Arterial deficiency in congenital clubfoot or congenital talipes equinovarus (CTEV) was postulated as either the primary cause of deformity or secondary manifestation of other bony and soft tissue abnormalities. The objectives of the study were to find any association between arterial deficiency with severity of CTEV and its treatment.

METHOD: This prospective study conducted on 24 feet with CTEV (18 babies) with Pirani score ranging between 2 to 6. Eighteen normal babies (36 feet) were selected as control. We used Color Doppler Ultrasound to assess dorsalis pedis and posterior tibial arteries before initiating the treatment. Second ultrasound was performed in study group upon completion of Ponseti treatment.

RESULTS: The patients were from one week to 15 weeks of life. Dorsalis pedis arterial flows were absent in 7 clubfeet (29.1%) while the remaining 17 clubfeet (70.8%) had normal flow. There was a significant association between Pirani severity score and vascular status in congenital clubfoot. There was a higher proportion of clubfeet having abnormal vascularity when the Pirani severity score was 5 and more. In study group, posterior tibial arteries were detectable and patent in all feet. All normal feet in control group had normal arterial flow. There was a significant difference in vascular flow before and after the Ponseti treatment (p 0.031).

CONCLUSION: The study concludes that there is an association between Pirani severity score and arterial deficiency in CTEV. Ponseti treatment is safe in CTEV with arterial deficiency and able to reconstitute the arterial flow in majority of cases.

Matched MeSH terms: Tibial Arteries/abnormalities

Massive paediatric pulmonary haemorrhage in Dieulafoy's disease: Roles of CT angiography, embolisation and bronchoscopy

Woodhull S, Bush A, Tang AL, Padley S

Paediatr Respir Rev, 2020 Nov;36:100-105.

PMID: 32680823 DOI: 10.1016/j.prrv.2020.06.001

Acute, major pulmonary haemorrhage in children, is rare, may be life-threatening and at times presents atypically. Dieulafoy's disease of the bronchus presenting with recurrent or massive hemoptysis was first described in adults. Prior to reviewing the literature, we report an illustrative case of bronchial Dieulafoy's disease (BDD) in a child presenting unusually with massive apparent hematemesis. The source of bleeding is a bronchial artery that fails to taper as it terminates within the bronchial submucosa. A high index of suspicion is required to identify such lesions via radiological imaging and the role of bronchial artery embolisation is highlighted with video images of angiography included.

Matched MeSH terms: Bronchial Arteries/abnormalities

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