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Bicornuate uterus: A case report
Abstracts / Journal of the Anatomical Society of India 66S (2017) S79–S125
Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2017.08.291 46 Bicornuate uterus: A case report Deepak Sharma ∗ , Vandana A. Sharma, Sonia S. Baweja, Ankit Jain GMC, Bhopal, India Introduction: Uterine anomalies are uncommon and are known to influence reproductive outcomes. The incidence of congenital uterine malformation is estimated to be 3–5%. A bicornuate uterus is commonly referred to as a “heart-shaped” uterus composed of two “horns” separated by a septum. Materials and methods: During routine dissection for undergraduate teaching in the Department of Anatomy, Gandhi Medical College, Bhopal (MP) a bicornuate uterus was found, removed in to, dissected and measurements taken. Results: Bicornuate uterus with normal tubes and ovaries was found during dissection. External features shows heart shaped bilobbed uterus with indentation in the cranio-central part with central groove extending from posterior to anterior surface of uterus. Inspection through external os shows complete septum attached to internal os. On probing, two separate right and left side opening extending towards right and left cornua of uterus seen. Right and left cornua measures 4 cm (width), 3.5cm (length) and 4.5 cm, 4.0 cm respectively. Openings of right and left cornu were 3.9 cm above external os. Thickness of septum was 1.9 cm. Discussion: Bicornuate uterus results from abnormal development of the paramesonephric ducts. There is partial failure of fusion of ducts, resulting in a uterus divided into two horns. 15% to 25% cases have problems with fertility and reproduction. With the introduction of radiological diagnostic techniques reproductive outcomes can be improved with better diagnosis and treatment. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2017.08.292 47 Tongue like projection of the left lobe of liver – A case report Kumar Dharmendra ∗ , R. Gurudiwan, C. Sarangi, C. Mohapatra SCB Medical College, Cuttack, Odisha, India Introduction: The liver which is the largest abdominal viscus of human body, usually has a larger right lobe and a smaller left lobe. Numerous variations have been mentioned in different literatures such as abnormal shape, accessory lobes, abnormal fissures, abnormal shape and position of gall bladder, Riedel’s lobe (which is a tongue like projection of right lobe of liver). The tongue like projection of left lobe of liver has rarely been mentioned in literature. Aims and objectives: Our aim is to highlight the anatomical variation of the left lobe of liver, which would be beneficial for anatomists, surgeons and radiologists. Materials/methods and observations: During routine undergraduate dissection of abdomen of a 45 year old female cadaver, an
S93
enlarged liver with tongue like projection of left lobe was observed. The liver occupied right hypochondrium, epigastrium and almost whole of left hypochondrium. The liver had a tongue like projection present in left lobe, 2–3 fissures on inferior/visceral surface of the left lobe and one prominent fissure on diaphragmatic surface dividing the left lobe into two parts. Conclusion: Hepatic variations such as accessory lobes, fissures etc. are very important for surgeons in planning biliary surgery, Porto systemic anastomosis, liver transplant etc. This variation is also useful for radiologists which should be kept in mind while diagnosing cases by USG, CT Scan, MRI etc. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2017.08.293 48 Case report of infrequent variation of third head of biceps brachii muscle Divya Chavda ∗ , Meghana Joshi, Bhavin Kodiyatar, Ila Sutterwala Government Medical College Baroda, Gujarat, India Introduction: During the routine formalin fixed cadaveric dissection of right arm of 65 year old male in the Department of Anatomy, Medical College Baroda; we observed a supernumerary head of biceps brachii muscle which is one of the muscle of anterior compartment of arm. Observation: It has two head, short and long head. Short head arises from the tip of the coracoid process of scapula and long head arises from the supraglenoid tubercle of humerus. The third head arises from the lower two-third of the medial side of brachialis muscle and fuses with the tendon of biceps brachii. The muscle was innervated by musculocutaneous nerve, and all other related structure was studied. The unusual course of the musculocutaneous nerve without piercing to the corachobrachialis muscle was observed. The nerve passed between the biceps and brachialis muscle and continued as lateral cutaneous nerve of forearm. Conclusion: Knowledge of such variation is important because the third head may provide additional strength to biceps during supination of forearm and elbow flexion irrespective of shoulder position. The presence of the variations may cause bone displacement subsequent to fracture. This variation may help to the surgeons while operating on the arm and to clinicians for diagnosing the nerve impairment. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2017.08.294
Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2017.08.291 46 Bicornuate uterus: A case report Deepak Sharma ∗ , Vandana A. Sharma, Sonia S. Baweja, Ankit Jain GMC, Bhopal, India Introduction: Uterine anomalies are uncommon and are known to influence reproductive outcomes. The incidence of congenital uterine malformation is estimated to be 3–5%. A bicornuate uterus is commonly referred to as a “heart-shaped” uterus composed of two “horns” separated by a septum. Materials and methods: During routine dissection for undergraduate teaching in the Department of Anatomy, Gandhi Medical College, Bhopal (MP) a bicornuate uterus was found, removed in to, dissected and measurements taken. Results: Bicornuate uterus with normal tubes and ovaries was found during dissection. External features shows heart shaped bilobbed uterus with indentation in the cranio-central part with central groove extending from posterior to anterior surface of uterus. Inspection through external os shows complete septum attached to internal os. On probing, two separate right and left side opening extending towards right and left cornua of uterus seen. Right and left cornua measures 4 cm (width), 3.5cm (length) and 4.5 cm, 4.0 cm respectively. Openings of right and left cornu were 3.9 cm above external os. Thickness of septum was 1.9 cm. Discussion: Bicornuate uterus results from abnormal development of the paramesonephric ducts. There is partial failure of fusion of ducts, resulting in a uterus divided into two horns. 15% to 25% cases have problems with fertility and reproduction. With the introduction of radiological diagnostic techniques reproductive outcomes can be improved with better diagnosis and treatment. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2017.08.292 47 Tongue like projection of the left lobe of liver – A case report Kumar Dharmendra ∗ , R. Gurudiwan, C. Sarangi, C. Mohapatra SCB Medical College, Cuttack, Odisha, India Introduction: The liver which is the largest abdominal viscus of human body, usually has a larger right lobe and a smaller left lobe. Numerous variations have been mentioned in different literatures such as abnormal shape, accessory lobes, abnormal fissures, abnormal shape and position of gall bladder, Riedel’s lobe (which is a tongue like projection of right lobe of liver). The tongue like projection of left lobe of liver has rarely been mentioned in literature. Aims and objectives: Our aim is to highlight the anatomical variation of the left lobe of liver, which would be beneficial for anatomists, surgeons and radiologists. Materials/methods and observations: During routine undergraduate dissection of abdomen of a 45 year old female cadaver, an
S93
enlarged liver with tongue like projection of left lobe was observed. The liver occupied right hypochondrium, epigastrium and almost whole of left hypochondrium. The liver had a tongue like projection present in left lobe, 2–3 fissures on inferior/visceral surface of the left lobe and one prominent fissure on diaphragmatic surface dividing the left lobe into two parts. Conclusion: Hepatic variations such as accessory lobes, fissures etc. are very important for surgeons in planning biliary surgery, Porto systemic anastomosis, liver transplant etc. This variation is also useful for radiologists which should be kept in mind while diagnosing cases by USG, CT Scan, MRI etc. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2017.08.293 48 Case report of infrequent variation of third head of biceps brachii muscle Divya Chavda ∗ , Meghana Joshi, Bhavin Kodiyatar, Ila Sutterwala Government Medical College Baroda, Gujarat, India Introduction: During the routine formalin fixed cadaveric dissection of right arm of 65 year old male in the Department of Anatomy, Medical College Baroda; we observed a supernumerary head of biceps brachii muscle which is one of the muscle of anterior compartment of arm. Observation: It has two head, short and long head. Short head arises from the tip of the coracoid process of scapula and long head arises from the supraglenoid tubercle of humerus. The third head arises from the lower two-third of the medial side of brachialis muscle and fuses with the tendon of biceps brachii. The muscle was innervated by musculocutaneous nerve, and all other related structure was studied. The unusual course of the musculocutaneous nerve without piercing to the corachobrachialis muscle was observed. The nerve passed between the biceps and brachialis muscle and continued as lateral cutaneous nerve of forearm. Conclusion: Knowledge of such variation is important because the third head may provide additional strength to biceps during supination of forearm and elbow flexion irrespective of shoulder position. The presence of the variations may cause bone displacement subsequent to fracture. This variation may help to the surgeons while operating on the arm and to clinicians for diagnosing the nerve impairment. Conflicts of interest The authors have none to declare. http://dx.doi.org/10.1016/j.jasi.2017.08.294