Anomalous Fissures Research Articles

A study of splenic notches in human cadavers and its clinical implications

: Spleen is the largest and secondary lymphoid organ with high vascularity which has important role in immunological and haematological functions of human body. Spleen developes from mesoderm and in the initial stages of development, different lobules are formed, which fuses later. The lobulated structure of spleen disappears, but is indicated by the presence of notches in superior border in adults. The aim of study was to find morphological variations of spleen with respect to its number of notches in borders and anomalous fissure on its surfaces.: The study was done on 40 formalin fixed cadaveric spleens from the department of Anatomy, Sri Siddhartha Medical College, Tumkur, and Karnataka. Out of 40 spleens studied, the various shapes such as wedge shaped, tetrahedral, oval and triangular were found. The number of spleen showing notches in superior border was 28(70%) and in the inferior border it was 3(7.5%). Absence of Splenic notches was observed in 5(12.5%) and 2(5%) spleens had notches in both borders. The anomalous fissure was found in 2(5%) spleen on its diaphragmatic surface.: The knowledge of variations in morphology of spleen are essential for physician, surgeon, radiologists and forensic surgeon to differentiate from the splenic pathology and splenic injury. Morphological variations of spleen and its clinical importance need to be discussed at dissection tables during routine anatomy dissection hours.

Accessory cardiac bronchus with associated lung parenchyma: rare congenital tracheobronchial anomaly.

Accessory cardiac bronchus (ACB) has been described mainly as case reports finding (frequency 0.08%-0.39%). Even though 50% of all ACBs have a blind extremity, imaging studies have demonstrated that some develop into a series of bronchioles with cystic degeneration or a ventilated lobule demarcated by an anomalous fissure and extremely rare with an abnormal pulmonary artery. In this case, ACB was demonstrated on several imaging methods arising from the intermediate bronchus's medial wall with correspondent blood vessels and fissure. Although an ACB is not a pathological entity and most patients with ACB are asymptomatic, it can become symptomatic due to recurrent infection, empyema, hemoptysis, and malignant transformation. In conclusion, both pulmonologists and radiologists should recognize normal bronchial anatomy and developmental bronchial anomalies, as these may be important to establish a correct diagnosis.

VARIATIONS OF SPLEEN MORPHOLOGY: A STUDY OF ADULT HUMAN CADAVERIC SPLEENS IN A MEDICAL INSTITUTE IN NORTH EAST INDIA

Background: The shape, size and weight of the spleen in human vary with age, sex, and under different conditions in the same individual. The idea of morphological variations is important to avoid misinterpretation of the splenic variants. 
 Objective: The objective is to assess and document variations of spleen morphology in human cadavers in a Medical Institute in North-East India.
 Methods: A cross sectional study of a total of 34 adult human cadaveric spleens was done in the Anatomy Department, Regional Institute of Medical Sciences (RIMS), Imphal, India. The study observed the morphological features such as shape, number of notches, anomalous fissures, and morphometric measurements such as length, breadth, thickness and weight of all the spleen specimens.
 Results: The wedge shaped spleen constituted 41.18% followed by triangular (23.53%), irregular (17.64%), oval (11.76%) and round (5.89%) shaped spleens. The maximum number of notches was present in the anterosuperior border and the number varied from 0-4 notches. There was no notch in 2.94% of the specimens. Mean values of splenic length, breadth and thickness were 9.91 cm, 6.14 cm and 3.35 cm respectively. The mean weight of the spleens was 149.09 g. Anomalous fissures were found on the diaphragmatic (2.94%) and visceral (2.94%) surfaces of the spleens.
 Conclusion: The study highlights morphological variations of spleens and splenic variations should be kept in mind by the radiologists and surgeons to avoid misinterpretation of splenic variants and unnecessary invasive procedures.
 Keywords: Spleen, Cadaver, Splenic variations

Prevalence of the Accessory Cardiac Bronchus on Multidetector Computed Tomography: Evaluation and Proposed Classification.

Accessory cardiac bronchus (ACB) is a very rare congenital anomaly and may cause some clinical complications, such as recurrent episodes of both infection and hemoptysis. The purpose of this study was to assess the multidetector computed tomography (MDCT) characteristics of ACB and to classify this anomaly according to the MDCT aspects. The routine thoracic CT scans from 5790 patients were evaluated retrospectively. The prevalence, location, length, diameter, division angle, distance from the carina, and the type of ACB were evaluated. A total of 12 ACBs were identified, with a prevalence of 0.2%. All ACBs originated from the intermediate bronchus. The median largest diameter of the ACBs was 7.75 mm (range: 5.8 to 10.30 mm), the median length was 12.1 mm (range: 8.6 to 35 mm), the median division angle was 61 degrees (range: 42 to 93 degrees), and the median distance from the carina was 16.95 mm (range: 5.7 to 22.20 mm). Six cases (50%) had a blind extremity (type 1: diverticulum or stump type), 3 cases (25%) had a mutiloculated cystic change at the end (type 2: cystic type), and 3 cases (25%) had a ventilated lobulus demarcated by an anomalous fissure (type 3: ventilated type). ACBs can be classified into 3 types according to their MDCT features. Recognition of ACB is important, as it is associated with clinical complications and is also salient in trauma cases.

Anomalous fissures and lobes of human lungs of North Indian population of western U.P.

IntroductionHuman lungs are normally divided into lobes by complete fissures which facilitate the movements of lobes in relation to one another during respiration. The knowledge of normal and abnormal fissures and lobes is important because it is essential to clinicians & radiologists in making correct diagnosis and treatment of lung diseases. Lack of knowledge misleads a doctor in proper localization of pathological lesions & their spread; interpretation of lung diseases in X-ray & CT Scan and in planning surgical approach during thoracoscopic lung resection. Keeping the above facts in mind the present study was aimed to look into the incidence of morphological variations of lung anatomy in North Indian population of western U.P. region. MethodThe present study was conducted on 50 pair of lungs obtained from the cadavers available in the department of Anatomy of Santosh Medical College, Ghaziabad, Uttar Pradesh. The lungs were assessed for any gross deformity and examined for analysis of fissures and lobes. ResultThe study on Right Lungs revealed the absence of oblique fissure in 8% and absence of Horizontal fissure in 40% of cases. The incidence of incomplete oblique fissure was 24% and that of incomplete Horizontal fissure was 32%. In 20% of the lungs there was complete absence of horizontal and oblique fissures. None of the right lungs showed any accessory fissure. A variation in fissural pattern accordingly caused variation in lobar patterns. A study on Left lung revealed incomplete oblique fissure in 40% and presence of accessory fissures in 24% of cases. The complete absence of oblique fissure on left side was not seen. DiscussionConsidering the clinical importance of normal and anomalous pattern of fissures and lobes of lungs, it becomes obligatory for us to have a fair knowledge of this subject so that no mistake is committed in diagnosing and treating a patient with lung pathology.

Anomalous accessory fissure of the middle lobe

Accessory fissure of the lungs is commonly observed in lung specimens, but are often unappreciated or misinterpreted on radiographs and computed tomography (CT) scans. Many pleural accessory and anomalous fissures have a merely academic significance yet, their recognition is important for many reasons. Our report describes an interesting case of anomalous accessory fissure of the middle lobe.

Variation in major pulmonary fissures: incidence in fetal postmortem examinations and a review of significant extrapulmonary structural abnormalities in sixty cases.

A retrospective study of 1513 fetal postmortem examination reports from 1967 to 1996 yielded 35 cases with anomalous major pulmonary fissures (2.3%), to which a further 25 cases were added from fetal postmortem examinations performed between 1929 and 1966. Of 60 cases with anomalous fissures, 43 had an absent right horizontal fissure and 8 had a supernumerary left horizontal fissure; the remaining 9 showed various patterns in which one lung lacked major fissures. Histological examination in 29 cases did not reveal any additional pulmonary abnormality and pulmonary maturity was appropriate for gestational age. Additional malformations were present in 40 cases and these were frequently multiple, the most common being central nervous system, cardiovascular, and genitourinary system defects; notable heart malformations (10 cases); hydrocephalus (5 cases); and cystic renal dysplasia (4 cases). Chromosomal abnormalities were demonstrated in six cases although this figure does not reflect their prevalence, as many cases predate the availability of karyotyping. In seven cases, including three with polysplenia syndrome and one with situs inversus totalis, there was evidence of an underlying abnormality of left-right asymmetry, and in 13 cases there was documented pulmonary hypoplasia.

Angelman and Prader‐Willi syndrome: A magnetic resonance imaging study of differences in cerebral structure

Recent improvements in magnetic resonance imaging techniques now allow the developing brain to be visualized in sufficient detail to perform "in vivo neuropathology." In this study we compared the cortical morphology in six children with Angelman and four with Prader-Willi syndrome. These two syndromes are of special interest because, although they are both caused by deletions in the same region of chromosome 15, Angelman children are far more severely affected, and do not speak. We measured the length of the banks of the Sylvian fissure in a gapless series of thin sagittal images. Angelman children had a significantly larger proportion (75%) of anomalous fissures than the Prader-Willi children (12%). Anomalous cortical growth could result from mistimed expression and recognition of macromolecules involved in axonal guidance, target recognition, and pruning. We hypothesize that misrouting of long projection axons may be related to the Sylvian fissure anomalies and the language disorder in Angelman syndrome.

A pitfall in the diagnosis of lobar collapse

In patients who have a superior accessory fissure, collapse of the upper or middle lobe may be overlooked as the anomalous fissure may be mistaken for the horizontal fissure on the postero-anterior view. Five cases are presented.

Particular Method of Applying Cauterization for the Reunion of Anomalous Fissures, and especially those of the Palate

Particular Method of Applying Cauterization for the Reunion of Anomalous Fissures, and especially those of the Palate