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腹主动脉及其分支:解剖变异与临床意义。

The abdominal aorta and its branches: anatomical variations and clinical implications.

作者信息

Mokhasi Varsha, Rajini T, Shashirekha M

机构信息

Department of Anatomy, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka, India.

出版信息

Folia Morphol (Warsz). 2011 Nov;70(4):282-6.

Abstract

BACKGROUND

Vascular variations regarding the branching pattern of the aorta are important in different laparoscopic surgeries, liver and kidney transplantation, oncologic resections, and various interventional radiological procedures in the abdominal region. The present work was undertaken on cadavers to examine the prevalence of vascular patterns of the important branches of the abdominal aorta.

MATERIAL AND METHODS

A total of 50 properly embalmed and formalin fixed cadavers were dissected in the abdominal region, and viscera were mobilised to expose the origin of important branches of the abdominal aorta. Celiac trunk, superior mesenteric, inferior mesenteric, right and left renal, left and right gonadal arteries, and the division of the abdominal aorta into right and left common iliac arteries were observed regarding their level of origin and for presence of any anatomical variations.

RESULTS

The celiac trunk origin was located at the level of the T12 vertebra in 64% of cadavers, superior mesenteric at L1 in 76%, inferior mesenteric at L3 in 68%, left and right renal at L1 in 82% and 80%, respectively, and left and right gonadal at L2 in 84% and 86%, respectively; whereas the aortic bifurcation was most common at the level of the L4 vertebra in 54% of cadavers. Important anatomical variations were photographed.

CONCLUSIONS

Defective fusion of the vitelline arteries during the embryonic stage resulted in the aforementioned anatomical variations. Knowledge of aortic variations is useful for appropriate radio diagnostic interventions and is helpful to decrease complications like vascular bleeding while ligating and anastomosing blood vessels, which is an integral part of many abdominal surgeries.

摘要

背景

在不同的腹腔镜手术、肝脏和肾脏移植、肿瘤切除以及腹部区域的各种介入放射学操作中,腹主动脉分支模式的血管变异很重要。本研究在尸体上进行,以检查腹主动脉重要分支的血管模式发生率。

材料与方法

总共解剖了50具经过适当防腐处理并用福尔马林固定的尸体的腹部区域,将内脏器官游离以暴露腹主动脉重要分支的起源。观察了腹腔干、肠系膜上动脉、肠系膜下动脉、左右肾动脉、左右性腺动脉以及腹主动脉分为左右髂总动脉的情况,包括其起源水平以及是否存在任何解剖变异。

结果

64%的尸体中腹腔干起源于T12椎体水平,76%的肠系膜上动脉起源于L1,68%的肠系膜下动脉起源于L3,82%的左肾动脉和80%的右肾动脉起源于L1,84%的左性腺动脉和86%的右性腺动脉起源于L2;而54%的尸体中主动脉分叉最常见于L4椎体水平。对重要的解剖变异进行了拍照。

结论

胚胎期卵黄动脉融合缺陷导致了上述解剖变异。了解主动脉变异有助于进行适当的放射诊断干预,并有助于减少在结扎和吻合血管时出现血管出血等并发症,而这是许多腹部手术不可或缺的一部分。

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