Suresh Rao

Unilateral congenital elongation of the cervical part of the internal carotid artery with kinking and looping: two case reports and review of the literature

Unilateral and bilateral variation in the course and elongation of the cervical (extracranial) part of the internal carotid artery (ICA) leading to its tortuosity, kinking and coiling or looping is not a rare condition, which could be caused by both embryological and acquired factors. Patients with such variations may be asymptomatic in some cases; in others, they can develop cerebrovascular symptoms due to carotid stenosis affecting cerebral circulation. The risk of transient ischemic attacks in patients with carotid stenosis is high and its surgical correction is indicated for the prevention of ischemic stroke. Detection of developmental variations of the ICA and evaluation of its stenotic areas is very important for surgical interventions and involves specific diagnostic imaging techniques for vascular lesions including contrast arteriography, duplex ultrasonography and magnetic resonance angiography. Examination of obtained images in cases of unusual and complicated variations of vascular pattern of the ICA may lead to confusion in interpretation of data. Awareness about details and topographic anatomy of variations of the ICA may serve as a useful guide for both radiologists and vascular surgeons. It may help to prevent diagnostic errors, influence surgical tactics and interventional procedures and avoid complications during the head and neck surgery. Our present study was conducted with a purpose of updating data about developmental variations of the ICA. Dissections of the main neurovascular bundle of the head and neck were performed on a total 14 human adult cadavers (10 – Africans: 7 males & 3 females and 4 – East Indians: all males). Two cases of unilateral congenital elongation of the cervical part of the ICA with kinking and looping and carotid stenoses were found only in African males. Here we present their detailed case reports with review of the literature.

Rare case of fetal gastroschisis with aplasia of the foot and external genital organs.

ABSTRACT  Gastroschisis is a rare anomaly and is usually not associated with any other congenital anomalies. The embryology of gastroschisis and omphalocele remains a matter of speculation. Incidences of gastroschisis are particularly high among pregnancies in very young women. The present case is reported because of its rare association with the condition of gastroschisis, disrupted omphalocele, with aplasia of the foot and external genital organs, as well as imperforate anus with distal rectal atresia.

Duplication of Right Ovarian Vein

We encountered a rare case of an anatomic variant of duplication of right ovarian vein in a 33 year old patient. Anatomic variant of the ovarian veins are extremely rare. However, with the increasing use of sophisticated diagnostic technology like computed tomography and magnetic resonance imaging these anatomical variant are more frequently diagnosed. The majority of venous anomalies are asymptomatic, however these variations can cause abnormal drainage, which could lead to clinical symptoms associated with the dysfunction of the vascular systems. Undiagnosed venous anomalies may lead to major complications during abdominal surgeries. Here we describe the detailed anatomical features of the area and discuss the related anatomical and developmental aspects.

Presence of Unusual Foramen in the Sternum – A Case Report

Presence of sternal foramen is a familiar variation of the sternum that brings the danger of fatal impediments like pneumothorax, damage to vital structures like pericardial and cardiac puncture during acupuncture. The present day autopsy population shows about 6.7% of bony defects in the sternum. When present it is seen in solitary and found in the body of the sternum, rarely multiply and may be found in the manubrium. Review of literature suggests that presence of unusual foramen in the sternum is found at the age of 8-years and also in the persons of old age. During routine visual inspection of the bone collection housed in the Department of Anatomy, in one of the sternum we observed the presence of sternal foramen and bifid xiphoid process. The sternal foramen was somewhat oval shaped measuring 6.75 mm × 5.55 mm, and was present in lower one third of the body of the sternum. The sternal foramen and the bifid xiphoid process when present will be usually asymptomatic. Sternal foramen can be misinterpreted sternal foramen can be misinterpreted as osteolytic lesion. Manifestation of sternum in close relation to the mediastinal structures, occurrence of sternal foramen makes the lung, heart and great vessels vulnerable while execution of invasive procedures like bone marrow aspiration, acupuncture leading to life threatening impediments such as pneumothorax and cardiac tamponade. Case Report Rao and Rao; ACRI, 10(1): 1-4, 2017; Article no.ACRI.36511 2