Background: Cervical sympathetic trunk (CST) is at risk of injury during surgical procedures of cervical spine and may result in Horner’s syndrome. The purpose of present study was to clearly describe the surgical anatomy of CST with respect to the surrounding structures and to analyse the anatomical variations.Methods: In this cross-sectional study, 50 cervical sympathetic chains were studied by bilateral neck dissections of 25 formalin fixed human cadavers from the Department of Anatomy, Government medical college Thrissur.Results: Cervical sympathetic chain was found inside the carotid sheath in 1 (2%) side of neck. Superior cervical ganglion (SCG) was consistently seen in all sympathetic chains. Middle cervical ganglion (MCG) was present in 27 (54%) chains studied; vertebral ganglion (VG) was present in 33 (66%) chains. Inferior cervical ganglion (ICG) was present in 38 (76%) CSTs. In case of stellate ganglion (SG), it was present in 12 (24%) chains. The most common type of CST was type 1 consisting of SCG, VG and ICG (17, 34%). Out of 25 cadavers studied, sympathetic chain appeared similar on right and left sides in 14 cadavers.Conclusions: This study concludes that variations occur in cervical sympathetic chain with regard to occurrence and measurements of its ganglia. Our study also emphasizes the need for awareness of the CST’s anatomy during cervical surgical procedures to prevent inadvertent injury to it.
Background: Genital ambiguity is a complex genetic disorder of sexual differentiation into male or female. The purpose of the present study is to correlate the sex of rearing with the genetic sex and to find out the prevalence of chromosomal anomalies in patients with ambiguous genitalia. The findings can help in proper diagnosis, genetic counselling, and the reassignment of sex, if necessary. Methods: In this cross-sectional study, 22 patients from north Kerala, ranging in age from 17 days to 17 years, were included. All cases were subjected to the following: a detailed history, physical examination, evaluation of clinical data, and cytogenetic analysis. Based on the standard protocol, peripheral blood lymphocyte culture was done. Chromosomal analysis was carried out with the help of an automated karyotyping system after G-banding of chromosomes.Results: Out of the 22 patients with ambiguous genitalia, 12 patients were genetic females with karyotype 46, XX, and nine patients were genetic males with 46, XY karyotype. One was a rare variant of Klinefelter syndrome with karyotype 49, XXXXY. The most common diagnosis was congenital adrenal hyperplasia, followed by partial androgen insensitivity syndrome. Discrepancies between genetic sex and sex of rearing were noted in 27% of the cases.Conclusions: This study unfolds the variable etiology of ambiguous genitalia and emphasizes the importance of karyotyping in diagnosis, proper assignment of the sex, and appropriate management of patients with genital ambiguity.
Background: Variations of the Hepatic Portal Vein are encountered during abdominal surgeries. Aim: The present study is an observational study of the extrahepatic part of Portal Vein & its variations on cadavers. Materials & Methods: A total of 50 upper abdomen dissections were carried out to delineate extra-hepatic Portal Vein anatomy. The Results: mean length of Portal Vein was 5.96cm. The mean diameter of Portal Vein was 1.35cm. The most common type of formation of Portal Vein was Type I, found in 64%. The Right Gastric Vein commonly emptied into the trunk of the Portal Vein. The Left Gastric Vein commonly emptied into the trunk of the Portal Vein in 87.18%. The most common type of Portal Vein termination was Extra-Hepatic, found in 76% of 50 dissections. The Bifurcation pattern was the most common pattern of Portal Vein termination, found in 94% of dissections. The ndings of the present Conclusion: study highlight the variations that may occur in the hepatic portal venous system in its extra-hepatic part. Sound knowledge of portal venous anatomy is needed for success in the surgeries of the liver & adjacent viscera.
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