Bifid or bifurcated ribs are a rare anatomical anomaly that accounts for approximately 28% of known rib abnormalities. Bifurcation always occurs at the sternal end of the rib and its two extremities are joined to a bifid costal cartilage. The presence of bifid rib is frequently accompanied by other anomalies, although this does not necessarily imply that it cannot occur as an isolated anomaly. The clinical significance of the latter has not been established. There have not been many studies done to investigate bifid rib closely aside from individual case reports, presumably due to the condition's extremely low incidence. However the detection of bifid ribs, though mostly incidental, has been proven advantageous for an early and wellrounded diagnosis It has also revealed significant preventive benefits especially in the pediatric patient population. This review is written to provide a comprehensive summary of what is known about bifid ribs and incorporate substantial findings from clinical cases that have been reported in past literature.

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Injection nerve palsy (INP) in the median nerve is an iatrogenic peripheral nerve injury that can be inflicted by a faulty intramuscular injection in the median nerve area. The literature reports a 2% incidence of INP among all peripheral nerve injuries. The incidence of INP in developed countries has decreased significantly during the past decade, but the injury appears to remain prevalent in developing countries. A deep understanding of the anatomy of the peripheral nerves, and a precise intramuscular injection technique, have been shown to be vital for preventing INP in the median nerve. Debates continue regarding what, if any, intervention is necessary for injection palsies; and if it is needed, when it should be carried out. In this article, we will review the literature related to median injection nerve palsy and recommended methods of prevention.

The relationship between cranial nerves and surrounding blood vessels is important to surgeons who operate in this region and radiologists who interpret cranial imaging. However, only sparse information is available regarding the potential for intracranial vessels to pierce cranial nerves. Therefore, the current comprehensive review was performed. Some reports do exist that describe this variant anatomy. Both veins and arteries have been reported to rarely pierce cranial nerves. Clinicians and surgeons should be aware of this possible derailment of normal anatomy as it could affect their patients or result in symptoms that do not have a precise etiology.

Transomental hernias (TOHs) are a rare finding, constituting a fraction of all intestinal hernias. Here, we report the cadaveric discovery of a spontaneous TOH involving the sigmoid colon in an 82-year-old female and discuss the relevant literature. To our knowledge, a TOH involving the sigmoid colon has not been previously reported.