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Cholecystohepatic duct: A case report
S44
j o u r n a l o f t h e a n a t o m i c a l s o c i e t y o f i n d i a 6 4 S ( 2 0 1 5 ) S37–S62
reliable information to the anatomists for learning and also for teaching of splenic anatomy. The details of the study will be discussed at the time of presentation.
25. Origin of pronator teres muscle by three heads: A case report
of the body of pancreas and reached up to left colic flexure, where it divided into ascending branch anastomosing with left branch of middle colic, and descending branch anastomosing with ascending branch of left colic artery proper. Knowledge of this anomalous origin and unusual course of the rare accessory left colic artery is surgically relevant, as it is liable to get injured during pancreatic surgeries and is essential in interpretation of radiological and vascular interventional studies.
T. Ahmad 1 , R.Q. Khan 2 1 Department of Anatomy, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India; 2 Department of Anatomy, MAMC, New Delhi, India
27. Cholecystohepatic duct: A case report
Introduction: The pronator teres is generally originated by the two heads, namely humeral and ulnar. The humeral head is the larger of the two, and begins above the medial epicondyle on the medial supracondylar ridge and the common flexor tendon. The ulnar head originates below the elbow on the medial side of the coronoid process of the ulna. The anatomical variations already have been noted and include the absence of ulnar head, additional slips from the medial intermuscular septum, from the Biceps, from the Brachialis and occasional hypertrophy of the muscle mass. Case Report: During routine anatomical dissection of the left upper extremity of an adult male cadaver, the pronator teres muscle was found to have an abnormal third head. This third head took its origin from fascia covering the flexor carpi radialis muscle. The three heads come together, cross the forearm diagonally and insert halfway down the lateral surface of the radius via a tendon. Such variations have clinical implications and therefore while managing patients with neurogenic pain in the wrist or a median nerve paralysis with symptoms of lower brachial artery or brachial vein compression, such anatomical variations should always be kept in mind.
Gauhati Medical College, Guwahati, Assam
Medhi Shobhana, K.L. Talukdar
Introduction: The human biliary tree is reported to present with a wide range of anatomical variations, so much so that a normal anatomic pattern is described to be non-existent. One of the reported variations of the biliary tree is the presence of some aberrant bile ducts called the Cholecystohepatic Ducts, which are described to be some persistent fetal connections between the liver and either the gallbladder or the extrahepatic bile ducts. True cholecystohepatic connections are rare. Though rare, knowledge of these variants is of utmost importance as failure to recognise them during surgeries, may be responsible for considerable morbidity following what should have been an uneventful surgical procedure. Case Report: We report such a rare case that was encountered during routine dissection of an adult female cadaver. In this case, a small, slender aberrant bile duct was found in the gallbladder fossa, connecting the right hepatic lobe with the gallbladder. The gallbladder was seen to be drained by a cystic duct that ultimately joined the common hepatic duct to form the common bile duct, which in turn drained into the second part of the duodenum. The rest of the extrahepatic biliary tree was found to be as per standard textbook descriptions.
26. Accessory left colic artery from middle colic artery and its surgical significance – A case report
28. Common bile duct duplication: A case report
S.B. Rangrej, S. Kakar, A. Mahajan
Medhi Shobhana, K.L. Talukdar
Maulana Azad Medical College, New Delhi, India
Gauhati Medical College, Guwahati, Assam, India
Introduction: Left colic artery normally arises as first branch of inferior mesenteric artery from its left side and supplies most of left colic flexure and descending colon. It run laterally and upwards, towards left colic flexure, where it divides into ascending and descending branches. The region of left colic flexure supplied by left colic artery along with adjoining transverse colon and descending colon can very rarely have an adjunct supply by an infrequent accessory left colic artery. Variable origin of accessory left colic artery has been reported earlier, but there is very minimal literature in Indian population. Case Report: During routine cadaveric dissection in a 40-yearold male cadaver, an anomalous accessory left colic artery was found. This artery was originating from middle colic artery before its division into right and left branches. It had an unusual course towards left side along the inferior border
Introduction: Common Bile Duct Duplication or Double Common Bile Duct (DCBD) is a rare congenital anomaly of the extra-hepatic biliary apparatus, characterised by the presence of two common bile ducts draining bile from different parts of the liver. One of them is seen to normally drain into the Major Duodenal Papilla and the other, which is named the Accessory Common Bile Duct (ACBD), drains into different parts of the upper gastro-intestinal tract (stomach, duodenum, ductus pancreaticus or septum). Awareness of is anomaly is of utmost importance as it is often reported to lead to complications such as choledocholithiasis, cholangitis, pancreatitis and upper gastro-intestinal malignancies. Besides, this condition is reported to be associated with Anomalous Pancreatico-Biliary Junction (APBJ) and choledochal cyst. Case Report: We present here, a unique variant of Double Common Bile Duct with anomalous union of the
j o u r n a l o f t h e a n a t o m i c a l s o c i e t y o f i n d i a 6 4 S ( 2 0 1 5 ) S37–S62
reliable information to the anatomists for learning and also for teaching of splenic anatomy. The details of the study will be discussed at the time of presentation.
25. Origin of pronator teres muscle by three heads: A case report
of the body of pancreas and reached up to left colic flexure, where it divided into ascending branch anastomosing with left branch of middle colic, and descending branch anastomosing with ascending branch of left colic artery proper. Knowledge of this anomalous origin and unusual course of the rare accessory left colic artery is surgically relevant, as it is liable to get injured during pancreatic surgeries and is essential in interpretation of radiological and vascular interventional studies.
T. Ahmad 1 , R.Q. Khan 2 1 Department of Anatomy, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India; 2 Department of Anatomy, MAMC, New Delhi, India
27. Cholecystohepatic duct: A case report
Introduction: The pronator teres is generally originated by the two heads, namely humeral and ulnar. The humeral head is the larger of the two, and begins above the medial epicondyle on the medial supracondylar ridge and the common flexor tendon. The ulnar head originates below the elbow on the medial side of the coronoid process of the ulna. The anatomical variations already have been noted and include the absence of ulnar head, additional slips from the medial intermuscular septum, from the Biceps, from the Brachialis and occasional hypertrophy of the muscle mass. Case Report: During routine anatomical dissection of the left upper extremity of an adult male cadaver, the pronator teres muscle was found to have an abnormal third head. This third head took its origin from fascia covering the flexor carpi radialis muscle. The three heads come together, cross the forearm diagonally and insert halfway down the lateral surface of the radius via a tendon. Such variations have clinical implications and therefore while managing patients with neurogenic pain in the wrist or a median nerve paralysis with symptoms of lower brachial artery or brachial vein compression, such anatomical variations should always be kept in mind.
Gauhati Medical College, Guwahati, Assam
Medhi Shobhana, K.L. Talukdar
Introduction: The human biliary tree is reported to present with a wide range of anatomical variations, so much so that a normal anatomic pattern is described to be non-existent. One of the reported variations of the biliary tree is the presence of some aberrant bile ducts called the Cholecystohepatic Ducts, which are described to be some persistent fetal connections between the liver and either the gallbladder or the extrahepatic bile ducts. True cholecystohepatic connections are rare. Though rare, knowledge of these variants is of utmost importance as failure to recognise them during surgeries, may be responsible for considerable morbidity following what should have been an uneventful surgical procedure. Case Report: We report such a rare case that was encountered during routine dissection of an adult female cadaver. In this case, a small, slender aberrant bile duct was found in the gallbladder fossa, connecting the right hepatic lobe with the gallbladder. The gallbladder was seen to be drained by a cystic duct that ultimately joined the common hepatic duct to form the common bile duct, which in turn drained into the second part of the duodenum. The rest of the extrahepatic biliary tree was found to be as per standard textbook descriptions.
26. Accessory left colic artery from middle colic artery and its surgical significance – A case report
28. Common bile duct duplication: A case report
S.B. Rangrej, S. Kakar, A. Mahajan
Medhi Shobhana, K.L. Talukdar
Maulana Azad Medical College, New Delhi, India
Gauhati Medical College, Guwahati, Assam, India
Introduction: Left colic artery normally arises as first branch of inferior mesenteric artery from its left side and supplies most of left colic flexure and descending colon. It run laterally and upwards, towards left colic flexure, where it divides into ascending and descending branches. The region of left colic flexure supplied by left colic artery along with adjoining transverse colon and descending colon can very rarely have an adjunct supply by an infrequent accessory left colic artery. Variable origin of accessory left colic artery has been reported earlier, but there is very minimal literature in Indian population. Case Report: During routine cadaveric dissection in a 40-yearold male cadaver, an anomalous accessory left colic artery was found. This artery was originating from middle colic artery before its division into right and left branches. It had an unusual course towards left side along the inferior border
Introduction: Common Bile Duct Duplication or Double Common Bile Duct (DCBD) is a rare congenital anomaly of the extra-hepatic biliary apparatus, characterised by the presence of two common bile ducts draining bile from different parts of the liver. One of them is seen to normally drain into the Major Duodenal Papilla and the other, which is named the Accessory Common Bile Duct (ACBD), drains into different parts of the upper gastro-intestinal tract (stomach, duodenum, ductus pancreaticus or septum). Awareness of is anomaly is of utmost importance as it is often reported to lead to complications such as choledocholithiasis, cholangitis, pancreatitis and upper gastro-intestinal malignancies. Besides, this condition is reported to be associated with Anomalous Pancreatico-Biliary Junction (APBJ) and choledochal cyst. Case Report: We present here, a unique variant of Double Common Bile Duct with anomalous union of the