Popliteal Vessels Entrapment by a Variant Accessory Belly of Medial Head of Gastrocnemius

Srinivasa Rao Sirasanagandla Bhagath Kumar Potu

doi:10.4172/2161-0940.1000116

Abstract

The present case report regards the incidental finding of right popliteal vessels entrapment by a variant accessory belly of the medial head of gastrocnemius. The accessory head of gastrocnemius took origin from the popliteal surface of the femur and joined the medial head. The popliteal vessels passed between the medial and the accessory head of the gastrocnemius. The accessory head was quite large and was supplied by a branch of tibial nerve. Popliteal vessels compression usually leads to a condition called popliteal vascular entrapment syndrome which is a rare clinical entity, predominantly in young adults. This anomaly might cause intermittent claudication, aneurysmal dilatation, thromboembolism and eventually limb-threatening ischemia. Early recognition and diagnosis is important to minimize surgical treatment and avoid vascular reconstruction. Knowledge about the rare anatomical variants of popliteal vessels is helpful for correct diagnosis and planning of treatment.

Highlights

The popliteal fossa is a narrow intermuscular space posterior to the knee joint that is bounded by biceps femoris tendon proximolaterally, semimembranosus muscle proximomedially, and medial and lateral heads of the gastrocnemius muscle distally
During routine dissection for medical students in the Department of Anatomy, Melaka Manipal Medical College, Manipal University, Manipal, India, we found an unusual relationship of popliteal vessels to the medial head of gastrocnemius
The anatomic variants of Popliteal Artery Entrapment Syndrome (PAES) were classified into various types by Love and Whelan based on the various relationships between the popliteal artery and the gastrocnemius muscle or, rarely, an anomalous fibrous band or the popliteus muscle [6]

Summary

Introduction

The popliteal fossa is a narrow intermuscular space posterior to the knee joint that is bounded by biceps femoris tendon proximolaterally, semimembranosus muscle proximomedially, and medial and lateral heads of the gastrocnemius muscle distally. The popliteal vessels normally course between the medial and lateral heads of gastrocnemius muscle. Anatomic variants of popliteal artery entrapment have been described in medical literature: aberrant path of popliteal artery related to the medial or lateral head of the gastrocnemius muscle; compression of a normally positioned artery by variant musculotendinous structures lying between the two heads of gastrocnemius; combination of a displaced artery and muscular variations [3].

Results

Conclusion