While there are relatively commonly observed, reported anatomical variations associated with the posterior abdominal wall, especially with the kidneys, we report here over a dozen variations in one prosected medical school donor body (Caucasian, male, age 87, cause of death: sepsis). These variations could contribute significantly to negative outcomes, especially in surgical procedures. During a routine dissection, we found bilateral extra‐renal pelvises. In the right kidney, there were two extra‐renal major calyxes, and five extra‐renal minor calyxes (two extra‐renal minor calyxes from the superior major calyxes, and three extra‐renal minor calyxes from inferior major calyxes). In the left kidney, there were four extra‐renal major calyxes and two extra‐renal minor calyxes off the most inferior major calyx. In addition, we found four venous variations and four arterial anomalies including one in a major artery. Namely, there were bilateral accessory renal veins found at the hilum that drained into the posterior aspect of the inferior vena cava. There was an additional accessory left renal vein that drained into the left renal vein, at the junction of the left testicular and left suprarenal veins. There was also a left lumbar vein that drained into one of the accessory left renal veins. Regarding the arterial supply to the kidneys, there were two polar right renal arteries directly off the abdominal aorta in addition to two long hilar right renal arteries, and three left hilar renal arteries that branched individually from the abdominal aorta. Finally, there was a long left common iliac artery compared to the right common iliac artery. Anatomical variations within patients can be of no significance or can turn a routine surgical procedure into a hazardous process if unrecognized at the time of intervention. Further documentation of such anatomical variations in prosected donor bodies can further inform surgeons for the need for imaging prior to various surgical procedures.
The common carotid artery (CCA) bifurcates into the external carotid artery (ECA) and internal carotid artery (ICA) at the level of the intervertebral disc between third and fourth cervical vertebra. After the bifurcation, the ICA normally lies posterolateral to the ECA. While ICA does not give off any branches in the neck, superior thyroid (STA), lingual (LA), facial artery, ascending pharyngeal, and occipital arteries arise from the ECA within the carotid triangle of the neck. During a routine dissection to demonstrate the neurovasculature of the neck, three anatomical variations in the arterial system were noted on the left side of a female donor body (Race: Caucasian, Age: 51 years). First, the CCA bifurcated into ECA and ICA below the level of the cricoid cartilage, approximately between the sixth and seventh cervical vertebra, at a distance of 5.7 cm from the arch of the aorta. Second, after the bifurcation, the ICA laid posteromedial to the ECA. Finally, despite the low bifurcation of CCA, STA and LA arose from a common thyrolingual trunk off the ECA (7.7 cm from the carotid bifurcation), between the second and third cervical vertebra. As a result, STA was 6 cm in length from its origin to its termination on the superior aspect of the thyroid gland. While each of these anatomical variations have been reported in the literature, to our knowledge, this is the first description of a ‘triple’ variation in the arterial network of the neck. Clinically, the knowledge of these anatomical variations may be important during surgical procedures involving the neck and its arterial network.
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