Introduction: The celiac trunk (CT) is one of the abdominal portion branches of the aortic artery and, together with the superior mesenteric and inferior mesenteric arteries, participates in the abdominal viscera vascularization through a series of anastomoses. Absence of CT or variation in the number of terminal branches implies in varied abdominal arteries origins, which may have implication in surgical approaches. Objective: To analyze the anatomical variations of the celiac trunk and possible associated surgical clinical implications. Methods:It is a systematic review of articles indexed in the PubMed, Lilacs, SciELO, Springerlink, Scienc Direct and Latindex databases from August to September 2017. Original articles involving the anatomical variations of the celiac trunk in humans were included. The presence/absence of the celiac trunk, the number of terminal branches and the place of origin of its branches in variant cases of the normal anatomical pattern, were considered for this study. Results: At the end of the research, 12 articles were selected, characterized by sample, anatomical structure evaluation method and main results. The normal anatomical pattern was the most prevalent in most studies (75.0%). CT was absent in 41.7% of the findings. The most prevalent anatomical variation was the presence of CT with bifurcation (66.7%). It was also observed the origin of the common and splenic hepatic arteries from the mesenteric arteries (25.0%). The presence of only one branch (16.7%) and quadrifurcation (8.33%) were other findings. Conclusion: CT variations are not uncommon findings, with different anatomic variants being reported. Thus, the importance of knowing the possible variations of this structure is emphasized, which may have implications for surgical interventions and imaging studies related to the abdominal region.
The sciatic nerve forms from the roots of the lumbosacral plexus and emerges from the pelvis passing inferiorly to the piriformis muscle, towards the lower limb where it divides into common tibial and fibular nerves. Anatomical variations related to the area where the nerve divides, as well as its path, seem to be factors related to piriformis syndrome. Objective: To analyze the anatomical variations of the sciatic nerve and its clinical implications. Methods: This was a systematic review of articles indexed in the PubMed, LILACS, SciELO, SpringerLink, ScienceDirect and Latindex databases from August to September 2018. Original articles covering variations of the sciatic nerve were included. The level of the sciatic nerve division and its path in relation to the piriformis muscle was considered for this study. The collection was performed by two independent reviewers. Results: At the end of the search, 12 articles were selected, characterized according to the sample, method of evaluation of the anatomical structure and the main results. The most prevalent anatomical variation was that the common fibular nerve passed through the piriformis muscle fibers (33.3%). Three studies (25%) also observed anatomical variations not classified in the literature and, in three (25%) the presence of a double piriformis muscle was found. Conclusion: The results of this review showed the most prevalent variations of the sciatic nerve and point to a possible association of this condition with piriformis syndrome. Therefore, these variations should be considered during the semiology of disorders involving parts of the lower limbs.
Introduction: introduction The obturator artery (OA) usually arises from the anterior trunk of the internal iliac artery. In the pelvis, it presents an anteroinferior course to the lateral wall, leading to the medial portion of the thigh, where it is divided into anterior and posterior branches. Through these, it provides supply to the pelvis and lower limbs structures. Although in most cases the OA follows the normal anatomical pattern, this is one of the structures with the greatest variations described. Objective: to describe morphometric aspects of a unilateral anatomical variation of the obturator artery originating from the posterior trunk of the internal iliac artery. Method: this is a case report, in which the anatomical variation was observed during a routine class in the anatomy laboratory at a university of Paraíba, Brazil, in 2018. A digital caliper was used to register morphometric aspects of the variant OA. Case report: when evaluating an adult male cadaver, a unilateral variation of the left OA was observed, which originated from the posterior division of the internal iliac artery. In the pelvis, the left OA presented an inferolateral course to the common trunk of the inferior gluteal and internal pudendal arteries. The right OA followed the anatomic-normal pattern. Conclusion An origin and course variability of the OA may have important implications in pelvic surgeries. Inadvertent lesions of this artery can lead to profuse and sometimes lethal bleeding. Therefore, it is important that surgeons and radiologists are aware of the possible variations of this structure for an adequate management of this region.
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