Background: Anatomic variations of cystic ducts are common and continuously encountered during Surgical and radiological interventions. Failure to identify these clinically important variations may result in complications during surgical or endoscopic procedures.Patients and methods: This is an observational descriptive cross-sectional study. 65 cadavers in the dissecting rooms of the medical colleges, in which the length and mode of insertion of cystic duct (CD) into common bile duct (CBD) were observed. Results:The mean length of the CD in the cadavers examined was (2.06 ± 1.03) with a minimum length of d" 0.5 cm and a maximum of 5 cm. Regarding the mode of insertion of CD into the CBD; 53.8% were found to have a low junction between the CD and common hepatic duct (CHD) which is considered the normal insertion. 46.2% found to be abnormal variations of insertion; short CD (d"0.5 cm) observed in 10.8%; whereas in 13.8% of cadavers we found that the CD is adherent to the CHD and runs in parallel to it. In 7.8% there was a high junction between the CD and CBD and in 9.2% we found that CD courses anterior or posterior to CBD and joins it medially.Conclusion: CD variations are not uncommon and it is important to identify these anatomical variations. A detailed knowledge of the extra hepatic biliary tract, as well as of its variations, is important for the diagnostic and therapeutic success in many clinical situations since they allow the surgeon prompt identification of certain pathologies, making surgical procedures more accurate and affective.

Key Clinical MessageEnteric duplication cyst is a very rare condition, the affected individual may be asymptomatic. It has serious complications, on top of which is a malignant transformation tendency. To avoid these complications, resection of the duplication seems to be mandatory, even if it is an incidental finding.

Background: Until recently, the knowledge of the anatomical variations in the relationship between the recurrent laryngeal nerve (RLN) and the inferior thyroid artery (ITA) combined with visual intraoperative RLN identification are essential for the protection of these life-important structures during surgical exposure and the mobilization of thyroid and parathyroid glands. This leads to the proper treatment of patients and improvement of the surgical techniques.Aim: To describe anatomical variations in the relationship of the recurrent laryngeal nerve to the inferior thyroid artery in the Sudanese population.Patients and methods: Following ethical committee approval, an observational descriptive prospective cross-sectional study in the period between March 2019 and February 2020, for anatomical variations in the relation of the recurrent laryngeal nerve to the inferior thyroid artery in seventy-two cervical sides of thirty-six well-dissected embalmed Sudanese cadavers. The RLN was investigated in three positions: posterior to the ITA main trunk, anterior to the ITA main trunk and between the ITA branches. Then, the results were analyzed according to the gender, age and dissection side.Results: We found that the anatomical variations were more frequent in males (97.2%) than females (2.8%). The age of these variations ranged between 31–45 years which represents (61.1%). On the right side of the neck, the commonest position of the RLN is posterior to the ITA (63.9%) followed by in decreasing order of frequency, the RLNs run between the ITA branches (30.6%) and anterior to the ITA (5.6%). On the left side of the neck, the commonest position of the RLN is posterior to the ITA (69.4%). It passed between the ITA branches in (30.6%) of specimens. There was no anterior location of the RLN to the ITA. Variations in a relationship of the RLN to the ITA on one side is significantly different from the opposite side.Conclusions: Although the risk of potential damage to the RLN during surgical neck procedures involving the thyroid gland and parathyroid glands is well recognized, pre-operative detailed surgeon’s knowledge for these frequent anatomical variations and the usage of the ITA as an anatomical landmark for intraoperative RLN recognition is important. This will lead to a reduction of iatrogenic RLN injury prevalence. Future studies are recommended to compare the findings on this cadaveric study with a larger sample size in the long-term period.