Nakatani T, Tanaka S, Mizukami S
Department of Anatomy II, School of Medicine, Kanazawa University, Japan.
Clin Anat. 1998;11(2):112-7. doi: 10.1002/(SICI)1098-2353(1998)11:2<112::AID-CA8>3.0.CO;2-W.
We report a rare case of three major vascular variations in the same individual, two within the thorax and abdomen and one within the upper extremity. The observations were made in a cadaver of a 74-year-old Japanese woman. A single left-sided inferior vena cava was observed that began from the confluence of the left and right common iliac veins and ascended vertically to the left side of the abdominal aorta. After receiving the left renal vein, it passed obliquely upward anterior to the abdominal aorta, reaching the right side of the aorta, and then ascended vertically to the right atrium, following its normal course. The retroesophageal right subclavian artery was also present; it arose from the arch of the aorta as the last branch, passing obliquely between the esophagus and the vertebral column. Thus the right recurrent laryngeal nerve was not formed. Additionally, bilateral superficial brachial arteries were observed. They arose from the axillary artery, crossed over the medial root of the median nerve, coursed down the arm, and divided into the radial and ulnar arteries in the cubital fossa. Although each variation is not rare by itself, the triad of events is rare and important to clinicians, anatomists, and medical students.
我们报告了一例罕见病例,同一个体出现三处主要血管变异,两处位于胸腹部,一处位于上肢。这些观察结果来自一名74岁日本女性的尸体。观察到一条左侧下腔静脉,它起始于左右髂总静脉汇合处,垂直向上至腹主动脉左侧。接纳左肾静脉后,它斜向上越过腹主动脉前方,到达主动脉右侧,然后沿正常路径垂直上升至右心房。还存在食管后右锁骨下动脉;它作为主动脉弓的最后一个分支发出,在食管与脊柱之间斜行穿过。因此未形成右喉返神经。此外,还观察到双侧肱浅动脉。它们起自腋动脉,跨过正中神经内侧根,沿手臂下行,在肘窝处分为桡动脉和尺动脉。虽然每种变异本身并不罕见,但这三种情况同时出现却很罕见,对临床医生、解剖学家和医学生来说具有重要意义。