The abdominal aorta and its branches: anatomical variations and clinical implications

• Autorzy: Prakash , Mokhasi V. , Rajini T. , Shashirekha M.
• Języki publikacji: EN

Abstrakty

EN

Background: Vascular variations regarding the branching pattern of the aorta are important in different laparoscopic surgeries, liver and kidney transplantation, oncologic resections, and various interventional radiological procedures in the abdominal region. The present work was undertaken on cadavers to examine the prevalence of vascular patterns of the important branches of the abdominal aorta. Material and methods: A total of 50 properly embalmed and formalin fixed cadavers were dissected in the abdominal region, and viscera were mobilised to expose the origin of important branches of the abdominal aorta. Celiac trunk, superior mesenteric, inferior mesenteric, right and left renal, left and right gonadal arteries, and the division of the abdominal aorta into right and left common iliac arteries were observed regarding their level of origin and for presence of any anatomical variations. Results: The celiac trunk origin was located at the level of the T12 vertebra in 64% of cadavers, superior mesenteric at L1 in 76%, inferior mesenteric at L3 in 68%, left and right renal at L1 in 82% and 80%, respectively, and left and right gonadal at L2 in 84% and 86%, respectively; whereas the aortic bifurcation was most common at the level of the L4 vertebra in 54% of cadavers. Important anatomical variations were photographed. Conclusions: Defective fusion of the vitelline arteries during the embryonic stage resulted in the aforementioned anatomical variations. Knowledge of aortic variations is useful for appropriate radio diagnostic interventions and is helpful to decrease complications like vascular bleeding while ligating and anastomosing blood vessels, which is an integral part of many abdominal surgeries. (Folia Morphol 2011; 70, 4: 282–286)

• Wydawca: -
• Czasopismo: Folia Morphologica
• Rocznik: 2011
• Tom: 70
• Numer: 4
• Opis fizyczny: p.282-286,fig.,ref.

Twórcy

autor

Prakash

• Department of Anatomy, Vydehi Institute of Medical Sciences and Research Centre, 82 EPIP Area, Whitefield, Bengaluru, Karnataka, India, 560066

autor

Mokhasi V.

• Department of Anatomy, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka, India

autor

Rajini T.

• Department of Anatomy, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka, India

autor

Shashirekha M.

• Department of Anatomy, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka, India

Bibliografia

• 1. Binbhu S, Venunadhan A, Banu Z, Danesh S (2010) Multiple variations in a single cadaver: A case report. Recent Research in Science and Technology, 2: 127–129.
• 2. Budhiraja V, Rastogi R, Asthana AK (2011) Variant origin of superior polar artery and unusual hilar branching pattern of renal artery with clinical correlation. Folia Morphol, 70: 24–28.
• 3. Degani S, Leibovitz Z, Shapiro I, Ohel G (2010) Variations of the origin of renal arteries in the fetus identified on power Doppler and 3D sonography. J Clin Ultrasound, 38: 59–65.
• 4. Ferrari R, De Cecco CN, Iafrate F, Paolantonio P, Rengo M, Laghi A (2007) Anatomical variations of the celiac trunk and the mesenteric arteries evaluated with 64-row CT angiography. Radiol Med, 112: 988–998.
• 5. Huang W, Ge G, Meng J, Xu Y (2010) High bifurcation of abdominal aorta upon horseshoe kidney at the level of upper L2 vertebral body: a rare case report. Surg Radiol Anat, 32: 605–608.
• 6. Inecikli MF, Kafa IM, Uysal M, Bakirci S, Oygucu IH (2010) Multiple variations of the branches of abdominal aorta. Intern J Anatom Variations, 3: 88–90.
• 7. Jetti R, Jevoor P, Vollala VR, Potu BK, Ravishankar M, Virupaxi R (2008) Multiple variations of the urogenital vascular system in a single cadaver: a case report. Cases J, 22: 344.
• 8. Koplay M, Onbas O, Alper F, Gulcan E, Kantarci M (2010) Multiple renal arteries: variations demonstrated by multidetector computed tomography angiography. Med Princ Pract, 19: 412–414.
• 9. Lakchayapakorn K, Siriprakarn Y (2008) Anatomical variations of the position of the aortic bifurcation, iliocava junction and iliac veins in relation to the lumbar vertebra. J Med Assoc Thai, 91: 1564–1570.
• 10. Moore KL, Dalley AF, Agur AMR (2010) Clinically oriented anatomy. 6th Ed. Lippincott Williams & Wilkins, New Delhi, pp. 314.
• 11. Oh E, Gross BH, Williams DM (1998) Independent origin of the hepatic and splenic arteries from the abdominal aorta: CT demonstration. J Comput Assist Tomogr, 22: 669–670.
• 12. Panagouli E, Tsaraklis A, Venieratos D (2011) A lower polar additional renal artery in an ectopic intraperitoneal kidney. Folia Morphol, 70: 56–58.
• 13. Panyanetinad O (2011) Rare combined variations of renal, testicular and suprarenal arteries. Internat J Anat Variations, 4: 17–19.
• 14. Paraskevas GK, Ioannidis O, Raikos A, Papaziogas B, Natsis K, Spyridakis I, Kitsoulis P (2011) High origin of a testicular artery: a case report and review of the literature. J Med Case Reports, 23: 75.
• 15. Pennington N, Soames RW (2005) The anterior visceral branches of the abdominal aorta and their relationship to the renal arteries. Surg Radiol Anat, 27: 395–403.
• 16. Pestemalci T, Mavi A, Yildiz YZ, Yildirim M, Gumusburun E (2009) Bilateral triple renal arteries. Saudi J Kidney Dis Transpl, 20: 468–470.
• 17. Raikos A, Paraskevas GK, Natsis K, Tzikas A, Njau SN (2010) Multiple variations in the branching pattern of the abdominal aorta. Rom J Morphol Embryol, 51: 585–587.
• 18. Ranade AV, Rai R, Prahbu LV, Mangala K, Nayak SR (2007) Arched left gonadal artery over the left renal vein associated with double left renal artery. Singapore Med J, 48: e332–4.
• 19. Sadlar TW (2004) Langman’s Medical Embryology. 9th Ed. Lippincott Williams and Wilkins, Philadelphia, pp. 255, 259, 333.
• 20. Shoja MM, Tubbs RS, Shakeri A, Ardalan MR, Rahimi-Ardabili B, Ghabili K (2008) Asymptomatic bilateral ureteropelvic junction obstruction due to supernumerary renal arteries. Saudi J Kidney Dis Transpl, 19: 806–808.
• 21. Songur A, Toktas M, Alkoc O, Acar T, Uzun I, Bas O, Ozen OA (2010) Abdominal aorta and its branches: morphometry — variations in autopsy cases. Eur J Gen Med, 7: 321–325.
• 22. Soni S, Wadha A (2010) Multiple variations in the paired arteries of abdominal aorta — clinical implications. J Clin Diagn Res, 4: 2622–2625.
• 23. Sridhar Varma K, Pamidi N, Vollala VR, Bolla SR (2010) Hepato-spleno-mesenteric trunk: a case report. Rom J Morphol Embryol, 51: 401–402.
• 24. Ucerler H, Asli Aktan Ikiz Z (2006) Multiplicity of the variations in ventral branches of abdominal aorta. Ital J Anat Embryol, 111: 15–22.
• 25. Ugurel MS, Battal B, Bozlar U, Nural MS, Tasar M, Ors F, Saglam M, Karademir I (2010) Anatomical variations of hepatic arterial system, celiac trunk and renal arteries: an analysis with multidetector CT angiography. Br J Radiol, 83: 661–667.
• 26. Uysal II, Cicekcibasi AE, Yilmaz MT, Seker M, Sanli O (2010) Multiple variations of the abdominal aorta in a single cadaver. Singapore Med J, 51: e94–e97.
• 27. Yi SQ, Li J, Terayama H, Naito M, Iimura A, Itoh M (2008) A rare case of inferior mesenteric artery arising from the superior mesenteric artery, with a review of the review of the literature. Surg Radiol Anat, 30: 159–165.
• 28. Zãhoi DE, Miclãuş G, Alexa A, Sztika D, Pusztai AM, Farca Ureche M (2010) Ectopic kidney with malrotation and bilateral multiple arteries diagnosed using CT angiography. Rom J Morphol Embryol, 51: 589–592.

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