The presence of an unusual innervation to the long head of the triceps brachii muscle, different as described in anatomical textbooks, may have clinical importance. The aim of this cadaveric study is to explore a possible contribution of the axillary nerve to the motor innervation of the long head of the triceps in a Puerto Rican population. We dissected the posterior cord of the brachial plexus in a supine position in embalmed cadavers, and the path of axillary nerve was followed to the quadrangular space. In a prone position, the posterior attachment of the deltoid muscle was cut to expose the long head of the triceps and its relation with the axillary nerve. After the dissection was carried out, many photographs were taken. The objective of this study was to clarify the motor innervation of the long head of the triceps brachii muscle because it has not been fully elucidated. The majority of anatomical textbooks state that the motor branch of the long head of the triceps brachii arises from the radial nerve. In our study, we found some specimens where the axillary nerve was innervating the long head of the triceps. It is very important to be aware about the presence of this variation in case the motor branch of the triceps muscle is used as a donor for nerve transfer. Recognizing this variation may also be important in radial nerve pathologies. In this clinical setting, muscle wasting would presumably be absent in the area innervated by the axillary nerve.
This is an unusual case report of 32-year-old Hispanic male who presented with an early-onset advanced stage colorectal cancer with an enterovesical fistula. A 32-year-old man presented to our institution referring suprapubic pain, urinary frequency, dysuria and tenesmus for several weeks suggesting Gouverneur’s syndrome. Patient had been treated with oral antibiotics for his recurrent urinary tract infections without resolution. Associated unintentional weight loss, decreased appetite and suprapubic pain raised concern for occult malignancy. Abdominopelvic computed tomography scan revealed a rectal mass with invasion to bladder. Colonoscopy biopsy confirmed diagnosis of moderately differentiated rectal adenocarcinoma. This report provides vital information about clinical presentations of enterovesical fistula in an imposed rectal adenocarcinoma in a young Hispanic adult with no previous family or medical history. A thorough clinical assessment must be taken to ensure accurate diagnosis and early detection of colorectal cancer in the young Hispanic population.
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