Patra Apurba, Chaudhary Anju, Asghar Adil, Chaudhary Priti
Department of Anatomy, All India Institute of Medical Sciences, Bathinda, India.
Department of Anatomy, All India Institute of Medical Sciences, Patna, India.
Anat Cell Biol. 2025 Jun 30;58(2):149-154. doi: 10.5115/acb.24.271. Epub 2025 Mar 5.
Sedillot's triangle (ST), formed between the sternal and clavicular heads of sternocleidomastoid (SCM) muscle, is often used as an anatomical landmark for internal jugular vein (IJV) cannulation, but its reliability has been questioned. This cadaveric study aimed to evaluate the effectiveness of ST in locating IJV. Dissections were performed on 23 adult cadavers (46 sides). ST was exposed, and a pin was inserted at its apex to assess its relationship with IJV. Dimensions of ST and distance between apex and IJV were measured (only in cases with unsuccessful puncture), along with IJV diameter at the apex. Showed that 92.00% of sides had a fully formed ST, while 8.00% (all left-sided) lacked a gap between the SCM heads. On right side, the needle corresponded directly with IJV in 19 (82.60%) cases, but missed laterally and medially in two (8.69%) cases each. On left side, successful IJV puncture occurred in 11 (61.11%) cases, with lateral and medial misses in five (27.77%) and two (11.11%) respectively. The mean height and width of ST was 64.30±7.86 mm and 20.08±6.26 mm on right side and 63.95±7.28 mm and 15.56±9.91 mm on left side. IJV diameter at the apex was significantly higher in male and on right side. Overall, right ST proved to be a reasonably reliable landmark for successful central venous catheter. However, anatomical variability, particularly on left side, suggests that caution should be exercised, and additional methods such as ultrasound guidance may improve the accuracy and safety of IJV cannulation using this approach.
塞迪洛三角（ST）由胸锁乳突肌（SCM）的胸骨头和锁骨头之间形成，常用于颈内静脉（IJV）插管的解剖标志，但对其可靠性存在质疑。本尸体研究旨在评估ST在定位IJV方面的有效性。对23具成年尸体（46侧）进行了解剖。暴露ST，并在其顶点插入一根针以评估其与IJV的关系。测量了ST的尺寸以及顶点与IJV之间的距离（仅在穿刺未成功的情况下），同时测量了顶点处IJV的直径。结果显示，92.00%的侧有完全形成的ST，而8.00%（均为左侧）的SCM头之间没有间隙。在右侧，19例（82.60%）针直接与IJV对应，但各有2例（8.69%）向外侧和内侧错过。在左侧，11例（61.11%）成功进行了IJV穿刺，分别有5例（27.77%）和2例（11.11%）向外侧和内侧错过。右侧ST的平均高度和宽度分别为64.30±7.86mm和20.08±6.26mm，左侧分别为63.95±7.28mm和15.56±9.91mm。顶点处IJV直径在男性和右侧显著更高。总体而言，右侧ST被证明是成功进行中心静脉置管的一个相当可靠的标志。然而，解剖变异，特别是在左侧，表明应谨慎操作，超声引导等额外方法可能会提高使用这种方法进行IJV插管的准确性和安全性。
