Search

Background: The superior mesenteric artery is one of the most important arteries in the abdominal cavity, which is of great clinical significance, especially in surgical procedures and fatal ischaemic complications. The aim of this study was to develop a clinical classification of the superior mesenteric artery. Material and methods: Postmortem contrast-enhanced computed tomography of 104 (29.8% female, age 50.7 ± 18.7 years) human bodies were analysed. Based on anatomic predisposition to ischaemic and iatrogenic complications, a 3-tiered clinical classification of the superior mesenteric artery was developed. Type 0 was defined as standard risk for ischaemic and iatrogenic complications. Type 1 was defined as increased thromboembolic risk with decreased risk of iatrogenic bleeding, and type 2 was defined as decreased ischaemic risk with increased risk of iatrogenic bleeding. The supply area of the superior mesenteric artery was divided into 4 regions: pancreas, caecum, ascending colon, and transverse colon. Results: Type 0 (standard risk) was found in 62.5% of cases. Type 1 was most frequently observed in the ascending colon region (15.4%). Type 2 was most frequently observed in the pancreatic region (17.3%). Regarding type, most abnormalities were found in the region of the ascending colon (18.3%), pancreas (17.3%), and transverse colon (16.3%). Conclusions: The proposed clinical classification of SMA links anatomic variations in morphology with their clinical significance. A simple, 3-level classification can be easily applied in daily practice and serve as a great support for preoperative evaluation and recognition of patients at risk of iatrogenic or thromboembolic complications [ABSTRACT FROM AUTHOR]

Background: The arterial supply of the large colon is provided by the superior mesenteric artery (SMA) and inferior mesenteric artery (IMA). A particularly important area, especially in the field of colorectal surgery, is the splenic flexure of the colon. There is a noticeable misunderstanding in the correct nomenclature of the major arterial anastomoses between SMA and IMA — Drummond’s Marginal Artery (DMA), Arc of Riolan (AOR), and Moskovitz Artery (MA). The aim of this study is to organise the nomenclature and propose a new simplified one to facilitate communication between physicians of various specialties. Materials and methods: Fourteen formalin-fixed cadavers (9 male, 5 female) accessible from the Chair of Anatomy of the Jagiellonian University Collegium Medicum were dissected to examine and describe the anatomical variations of anastomoses between SMA and IMA. Results: The artery of Drummond was present in all 14 specimens maintaining the continuity of the vessel along its entire course. The Arc of Riolan was found in 7 out of 14 cadavers (50%). The artery of Moskovitz was not found. The average length measured between IMA and aortic bifurcation and between IMA and SMA was 51.00 mm and 84.68 mm, respectively. Conclusions: SMA and IMA anastomoses form an arterial network that is characterised by high variability and trail in surgically strategic areas. For this reason, simplifying the terminology and using unambiguous names of these vessels based on their trail and anatomical relationship with IMV are crucial for the proper planning and execution of surgical procedures performed on the colon. [ABSTRACT FROM AUTHOR]

Background: Anatomical research based on deceased body specimens is a time-consuming process that requires a great deal of skill and time to perform correctly. Three-dimensional medical image analysis is an excellent tool for anatomic evaluation, but it often includes patients with comorbidities in the study group, which can skew the results. The purpose of this study was to develop and evaluate methods for anatomic research based on postmortem contrast-enhanced computed tomography angiography 3D reconstruction of the coeliac trunk. Materials and methods: Postmortem contrast-enhanced computed tomography angiography of 105 (28.6% female, age 50.8 ± 18.7) decedents without abdominal trauma or tumour was analysed. The abdominal portion of the aorta and the coeliac trunk with its branches were reconstructed and evaluated. The type of coeliac trunk was evaluated. The results were analysed. Results: The coeliac trunk, splenic artery, and common hepatic artery were visualized in all cases. The left gastric artery was visible in 97.1% of cases. The dorsal pancreatic artery was visualized in 61.0% of cases. The most common type of coeliac trunk was 1 (88.6%), and the rarest types were 2, 3, and 6 (1.0%). We observed 4 morphologies of the truncus coeliacus that did not fit the classification presented previously. Conclusions: This study has demonstrated that three-dimensional reconstruction of postmortem contrast-enhanced computed tomography is an excellent tool for performing accurate morphometric analyses for anatomic research purposes. This method can serve as a source for anatomic studies in the healthy population. [ABSTRACT FROM AUTHOR]

With the advent of breast conservation options in the 1970s, as well as wider acceptance of breast reconstruction in cancer patients in 1980/1990, ending up with evolution of oncoplastic concepts in the early 2000s, detailed surgical anatomy of the breast became important. This short article reviews surgical anatomy of breast with particular emphasis on innervation and blood supply to the skin and nipple-areolar complex, as well as points out the concept of compartmental breast cancer anatomy. Meticulous dissection and avoidance of transection of major vessels and nerves constitutes the crucial factor for satisfactory results of surgery in terms of preservation of sensation as well as appropriate vitality of skin. [ABSTRACT FROM AUTHOR]