A persistent vitelline artery in an adult. Case report and review of literature

Lemke, Cornelius; Biedermann, Uta

doi:10.1016/j.tria.2020.100080

Cited by 5 publications

(7 citation statements)

References 22 publications

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“…Similarly, because branches of the VA supply the initial yolk sac, multiple VAs are likely to be present even after regression of the sac. These branches, however, seemed not to correspond to multisegmental vitelline VAs of the type often shown in reviews [19] and textbooks [1]. Photographic evaluation of mouse embryos showed the presence of multisegmental arterial roots from the aorta at E 9.5-10.5 [20].…”

Section: Discussionmentioning

confidence: 91%

“…Many recent studies have shown persistent vitelline vessels running along the umbilical cord surface at birth. However, it is difficult to determine whether these thin vessels are actual remnants or develop secondarily as collaterals of the embryonic umbilical vein [19,21,22]. These veins in adults, have sometimes been called umbilical veins [23], resulting in serious confusion between embryonic umbilical and vitelline veins.…”

Section: Discussionmentioning

confidence: 99%

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Topographical relationships of the yolk sac remnant and vitelline vessels with the midgut loop in the extra-embryonic coelom of human embryos

et al. 2022

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The yolk sac is supplied by the vitelline artery and vein (VA, VV), which run through the yolk stalk in combination with the omphaloenteric duct. Moreover, the VV takes a free posterior course outside the midgut mesentery containing the secondarily-developed superior mesenteric vein (SMV). However, the regression process of these structures has not been demonstrated photographically. The present study evaluated serial histological sections from 20 embryos of stages 15-19 or crown-rump length (CRL) 7.5-20 mm. All specimens carried the SMV as sequential tissue slits. However, an omphaloenteric duct with epithelia continuous with the midgut loop was not observed. In smaller embryos (CRL <13 mm) the VA extended distally or anteriorly from the midgut apex in the extra-embryonic coelom, whereas in larger embryos (CRL 16-20 mm) the artery was absent from the distal side of the apex. The entire course or part of the VV outside the mesentery was always seen, but four larger embryos lacked the venous terminal near the duodenum. A vacuole-like remnant of the yolk sac was present in all smaller embryos (CRL <10 mm), but was absent from 7 of the 11 larger embryos. The size of the remnant was equal to the thickness of the VA or VV, with the remnant being sandwiched between the VA and VV. Moreover, the regressing yolk sac often communicated with or opened to the VV. Consequently, the yolk sac regressed first, followed by the regression of the VA until 6 weeks. The yolk stalk was clearly observed until 5 weeks.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Topographical relationships of the yolk sac remnant and vitelline vessels with the midgut loop in the extra-embryonic coelom of human embryos

et al. 2022

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“…The literature around vitelline vessel remnants (VVRs) diagnosed at birth or in adults is confusing. Recently, several reports have shown the persistence of arterial or anteriovenous VVRs running below the surface of 4-10% of umbilical cords at birth [3,19], such structures have also been reported to persist in adults [8, 12,13]. Finally, the digitized series of DREM embryos (http://virtualhumanembryo.lsuhsc.edu/) demonstrate not only the right VV remnant but also the vitelline artery remnant free from the midgut mesentery in the herniation sac of the CS18 and CS23 embryos.…”

Section: Discussionmentioning

confidence: 99%

Human vitelline vein remnant originating from the umbilical cord, passing though the extracelomic cavity of physiological herniation and ending at the midgut mesentery

Kim

Jin

Yamamoto

et al. 2022

Preprint

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Purpose: The mechanism and timing of the degeneration and disappearance of the upstream portion of the human vitelline vein (VV) are unclear. Methods: Sagittal and horizontal histological sections from eight embryos and 19 fetuses (gestational age approximately 6-12 weeks; crown-rump length 11-61 mm) were examined. Results: Two types of VV candidates were observed: a long VV on the right superior side of the mesentery of the jejunum (VV1) and a short VV on the left inferior side of the mesentery (VV2). The VV1, observed in 12 specimens, was 20-30 microns in diameter and ran dorsally between the right liver lobe and the jejunum, subsequently merging with an initial superior mesenteric vein on the pancreatic head immediately below the superior portion of the duodenum. The VV2, observed in four specimens, passed dorsally between loops of the ileum on the left side of the mesentery of the ileum and ended at the mesentery. Many of these candidates did not originate from the umbilical cord but suddenly started in the sack of physiological herniation. Conclusions: At 10-12 weeks, the VV candidates originated from the umbilicus and were involved by the expanding greater omentum. The right-sided and left-sided VVs seemed to correspond to right and left VV remnants, respectively, and both took an upstream course outside the mesentery of the jejunum and ileum. The right VV upstream portion was likely to disappear later than the left one, but the timing of degeneration varied greatly among individuals, depending on the topographical relationship between the right liver lobe and the jejunum.

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“…At the end of the third week of gestation, an arterial plexus emerges from the paired dorsal aortae. The arterial plexus connects to the vascular system of the yolk sac and gives rise to the vitelline arteries [ 13 ]. The vitelline branches of the fetal abdominal aorta become the blood supply to the gut and are connected by a central longitudinal anastomosis [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Three of the vitelline segments arising from the fetal abdominal aorta (10th, 13th, and 21st) persist to form the coeliac trunk, superior mesenteric artery, and inferior mesenteric artery, respectively [ 15 ]. These three vessels are formed on day 41 of gestation [ 13 ]. Variations of the coeliac trunk and superior mesenteric artery can occur due to the disappearance or survival of the ventral longitudinal anastomosis, between the vitelline branches of the abdominal aorta [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

A New Arterial Variation Involving a Pentafurcated Coeliac Trunk

Lastoria¹,

Haiser²,

Opoka³

2022

Cureus

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We present a newly found variation of the coeliac trunk. The variation may have clinical implications during surgery and radiological investigations. Open abdominal dissection of an embalmed 65-year-old female cadaver, whose cause of death was metastatic breast carcinoma, was performed in the King's College London dissection laboratory. Standard, student issue cadaveric dissection equipment was used. A new variation of the coeliac trunk was observed. The variation was a pentafurcated coeliac trunk, with additional arterial variations. The left gastric artery, splenic artery, gastroduodenal artery, middle colic artery, and jejunoileal artery emerged directly from the coeliac trunk. The proper hepatic artery emerged directly from the superior mesenteric artery. The literature review did not reveal the combination of variations that we report. This case reports a new combination of arterial variations. It adds to the knowledge of surgeons and radiologists and highlights the importance of awareness of anatomical variations. Knowledge of anatomical variations may improve patient outcomes.

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A persistent vitelline artery in an adult. Case report and review of literature

Cited by 5 publications

References 22 publications

Topographical relationships of the yolk sac remnant and vitelline vessels with the midgut loop in the extra-embryonic coelom of human embryos

Topographical relationships of the yolk sac remnant and vitelline vessels with the midgut loop in the extra-embryonic coelom of human embryos

Human vitelline vein remnant originating from the umbilical cord, passing though the extracelomic cavity of physiological herniation and ending at the midgut mesentery

A New Arterial Variation Involving a Pentafurcated Coeliac Trunk

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