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Battledore placenta – A case report
S84
Abstracts / Journal of the Anatomical Society of India 66S (2017) S79–S125
Radiologists should rule out these normal anatomic variants while performing ultrasonography. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2017.08.262 17 Battledore placenta – A case report Saikia Mrinmoy ∗ , Talukdar Hrishikes, K.L. Talukdar Department of Anatomy, Gauhati Medical College and Hospital, India Introduction: Battledore placenta is a placenta in which the umbilical cord is attached at the placental margin; so called because of the fancied resemblance to the racquet used in badminton. The shortest distance between the cord insertion and placental edge is within 2 cm. The incidence of battledore placenta is 7–9% in singleton pregnancies, and 24–33% in twin pregnancies. Three theories regarding the cause of marginal insertion of the umbilical cord have been proposed: first is the “blastocyst polarity”, the second is the “abnormal placental development because of decreased chorionic vessel branching” and the third one is the “trophotropism/placental migration”. Case report: A 26-year old lady delivered a live male baby weighing 2.2 kg after 36 weeks of gestation, in the Department of Obstetrics and Gynaecology of Gauhati Medical College and Hospital. The baby breathed and suckled normally. The placenta from the delivery was collected with the permission of the above department and studied in the Department of Anatomy of Gauhati Medical College. The umbilical cord was found to be attached to the margin of the placenta. There was no other gross anomaly in the placenta. Discussion: Battledore placenta is associated with perinatal complications like fetal distress, intrauterine growth restriction and preterm labor. Conclusion: Antenatal ultrasound diagnosis of umbilical cord abnormalities can help in improving neonatal outcome. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2017.08.263 18 Variations in the branching pattern of the aortic arch – Its embryological basis and clinical significance Niyati Airan ∗ , Amal Rani Das, S.K. Mishra, K.K. Agrawal, Anil Dwivedi Veer Chandra Singh Garhwali Government Medical Science & Research Institute, Srinagar, Uttarakhand, India Introduction: The aortic arch is a continuation of the ascending aorta, being located in the superior mediastinum. The aortic arch and its branches are subject to numerous variations. Variant aortic arch branching patterns arise as a result of altered development from primitive aortic arches of the embryo during the early gestation period.
Materials and methods: During routine educational dissection, variant branching pattern of aortic arch were observed in two male cadavers. Observation: In the first cadaver, the left vertebral artery was seen to be arising from the aortic arch itself between left common carotid artery and left subclavian artery. The diameter of the vertebral artery was smaller than the other branches of the aortic arch. In the second cadaver Brachiocephalic trunk and left common carotid artery were arising from a common trunk from the aortic arch with left subclavian artery arising as a second branch left to the common trunk. Conclusion: Anatomical variations in the branching pattern of arch of aorta are significant during diagnostic, surgical, and interventional procedures of thorax and neck. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2017.08.264 19 Cloacal extrophy – A rare case report of OEIS complex Seema Khambatta ∗ , Hemanshi Shah T. N. Medical College & B. Y. L. Nair CH. Hospital, India Introduction: Cloacal extrophy is a rare congenital defect (1 in 200,000–400,000 live births) and comprises the most severe deformation of the EEC (extrophy–epispadias complex) spectrum. It is also called the OEIS complex (omphalocoele, extrophy, imperforate anus and spinal defect), when urogenital, gastrointestinal, skeletal and neurospinal malformations are present. The hindgut and caecum are extrophied between the two halves of the bladder along with malformations of male or female genitalia. The embryological defect in cloacal extrophy is due to failure of migration of mesodermal cells in the infra-umbilical part of the anterior abdominal wall and abnormal development and premature rupture of the cloacal membrane. Observation: A one-day old female infant presented in the paediatric surgery department of our institute with absent anal opening and a large mass in the lower abdominal wall with egress of urine and split genitalia. A small swelling was present in the sacral region. On examination, anterior abdominal wall was absent in the infra-umbilical region and the mass showed an omphalocoele in the upper part. The lower part of the mass showed two hemi-bladders on either side of the ileo-caecal plate, with urine dribbling from the ureteric orifices. Clitoris was split and the anal opening was absent. A small meningocoele was present in the sacral region. The child was operated, closing the abdominal wall defect. The ureters and urethra were catheterised and an ileostomy was performed. However the patient succumbed to septicaemia one month later. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2017.08.265
Abstracts / Journal of the Anatomical Society of India 66S (2017) S79–S125
Radiologists should rule out these normal anatomic variants while performing ultrasonography. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2017.08.262 17 Battledore placenta – A case report Saikia Mrinmoy ∗ , Talukdar Hrishikes, K.L. Talukdar Department of Anatomy, Gauhati Medical College and Hospital, India Introduction: Battledore placenta is a placenta in which the umbilical cord is attached at the placental margin; so called because of the fancied resemblance to the racquet used in badminton. The shortest distance between the cord insertion and placental edge is within 2 cm. The incidence of battledore placenta is 7–9% in singleton pregnancies, and 24–33% in twin pregnancies. Three theories regarding the cause of marginal insertion of the umbilical cord have been proposed: first is the “blastocyst polarity”, the second is the “abnormal placental development because of decreased chorionic vessel branching” and the third one is the “trophotropism/placental migration”. Case report: A 26-year old lady delivered a live male baby weighing 2.2 kg after 36 weeks of gestation, in the Department of Obstetrics and Gynaecology of Gauhati Medical College and Hospital. The baby breathed and suckled normally. The placenta from the delivery was collected with the permission of the above department and studied in the Department of Anatomy of Gauhati Medical College. The umbilical cord was found to be attached to the margin of the placenta. There was no other gross anomaly in the placenta. Discussion: Battledore placenta is associated with perinatal complications like fetal distress, intrauterine growth restriction and preterm labor. Conclusion: Antenatal ultrasound diagnosis of umbilical cord abnormalities can help in improving neonatal outcome. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2017.08.263 18 Variations in the branching pattern of the aortic arch – Its embryological basis and clinical significance Niyati Airan ∗ , Amal Rani Das, S.K. Mishra, K.K. Agrawal, Anil Dwivedi Veer Chandra Singh Garhwali Government Medical Science & Research Institute, Srinagar, Uttarakhand, India Introduction: The aortic arch is a continuation of the ascending aorta, being located in the superior mediastinum. The aortic arch and its branches are subject to numerous variations. Variant aortic arch branching patterns arise as a result of altered development from primitive aortic arches of the embryo during the early gestation period.
Materials and methods: During routine educational dissection, variant branching pattern of aortic arch were observed in two male cadavers. Observation: In the first cadaver, the left vertebral artery was seen to be arising from the aortic arch itself between left common carotid artery and left subclavian artery. The diameter of the vertebral artery was smaller than the other branches of the aortic arch. In the second cadaver Brachiocephalic trunk and left common carotid artery were arising from a common trunk from the aortic arch with left subclavian artery arising as a second branch left to the common trunk. Conclusion: Anatomical variations in the branching pattern of arch of aorta are significant during diagnostic, surgical, and interventional procedures of thorax and neck. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2017.08.264 19 Cloacal extrophy – A rare case report of OEIS complex Seema Khambatta ∗ , Hemanshi Shah T. N. Medical College & B. Y. L. Nair CH. Hospital, India Introduction: Cloacal extrophy is a rare congenital defect (1 in 200,000–400,000 live births) and comprises the most severe deformation of the EEC (extrophy–epispadias complex) spectrum. It is also called the OEIS complex (omphalocoele, extrophy, imperforate anus and spinal defect), when urogenital, gastrointestinal, skeletal and neurospinal malformations are present. The hindgut and caecum are extrophied between the two halves of the bladder along with malformations of male or female genitalia. The embryological defect in cloacal extrophy is due to failure of migration of mesodermal cells in the infra-umbilical part of the anterior abdominal wall and abnormal development and premature rupture of the cloacal membrane. Observation: A one-day old female infant presented in the paediatric surgery department of our institute with absent anal opening and a large mass in the lower abdominal wall with egress of urine and split genitalia. A small swelling was present in the sacral region. On examination, anterior abdominal wall was absent in the infra-umbilical region and the mass showed an omphalocoele in the upper part. The lower part of the mass showed two hemi-bladders on either side of the ileo-caecal plate, with urine dribbling from the ureteric orifices. Clitoris was split and the anal opening was absent. A small meningocoele was present in the sacral region. The child was operated, closing the abdominal wall defect. The ureters and urethra were catheterised and an ileostomy was performed. However the patient succumbed to septicaemia one month later. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2017.08.265