Moynihan’s Hump: Our Eyes See What Our Mind Knows

Raghuwanshi, Deepak Singh; Ram, Mahesh; Khan, Shehtaj; Anand, Krishnanand

doi:10.1007/s12262-020-02535-x

Cited by 5 publications

(8 citation statements)

References 5 publications

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Section: Discussionmentioning

confidence: 99%

“…A Moynihan’s hump or caterpillar configuration of the RHA is a rare anomaly, with an incidence reported to be between 1.3% and 13.3% [ 5 , 12 , 28 – 30 ]. The tortuous RHA can form a single or double loop, and pass posteriorly or anteriorly to the common hepatic duct, with the posterior presentation being the most common [ 5 , 12 , 30 ]. When a double loop is present, the cystic artery can arise from the proximal part and cross over the RHA before reaching the gallbladder, or it can originate from the distal part and be extremely short [ 5 , 12 , 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…The tortuous RHA can form a single or double loop, and pass posteriorly or anteriorly to the common hepatic duct, with the posterior presentation being the most common [ 5 , 12 , 30 ]. When a double loop is present, the cystic artery can arise from the proximal part and cross over the RHA before reaching the gallbladder, or it can originate from the distal part and be extremely short [ 5 , 12 , 30 , 31 ]. The latter is more common [ 12 , 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

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A 56-Year-Old Woman with Acute Cholecystitis and a Moynihan’s Hump, or Caterpillar Configuration, of the Right Hepatic Artery Identified During Laparoscopic Cholecystectomy

et al. 2022

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Patient: Female, 56-year-old Final Diagnosis: Cholecystitis and caterpillar configuration Symptoms: Abdominal pain in the right upper quadrant • nausea • vomiting and abnormal warm and cold sensation Medication: — Clinical Procedure: — Specialty: Surgery Objective: Rare disease Background: When performing a cholecystectomy, several variations can be encountered by the surgeon. The “Moynihan’s hump” or “caterpillar configuration” of the right hepatic artery are the terms used to describe a tortuous right hepatic artery running proximal or parallel to the cystic duct, resulting in a small or short cystic artery and occupying most of Calot’s triangle. This report is of a 56-year-old woman with acute cholecystitis and a Moynihan’s hump or caterpillar configuration identified at laparoscopic cholecystectomy. Case Report: A 56-year-old woman presented herself to the Emergency Department with abdominal pain in the right upper quadrant for a week, associated with nausea, vomiting, and abnormal warm and cold sensation. Acute cholecystitis was diagnosed with ultrasound, and a laparoscopic cholecystectomy using a 4-port technique was performed. During the dissection of Calot’s triangle, a large pulsatile vessel forming a loop was found, which turned out to be the right hepatic artery. The anatomic variation that was observed during the procedure is called Moynihan’s hump or caterpillar configuration of the right hepatic artery. The surgery was uneventful, and the patient was discharged the next day. Conclusions: The Moynihan’s hump or caterpillar configuration of the right hepatic artery is a rare anomaly, with an incidence reported to be between 1.3% and 13.3%. This report has shown that although a Moynihan’s hump or caterpillar configuration of the right hepatic artery is rare, the surgeon should be aware of this anatomic anomaly when performing gallbladder surgery to prevent arterial damage and operative complications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A 56-Year-Old Woman with Acute Cholecystitis and a Moynihan’s Hump, or Caterpillar Configuration, of the Right Hepatic Artery Identified During Laparoscopic Cholecystectomy

et al. 2022

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“…The incidence of caterpillar hump or Moynihan's hump and RHA varies from approximately 1.3 to 13.3% [2] , [6] , [10] , [11] . The etiology is still not entirely clear, however, there are some theories described in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…The CA, when arising from the proximal loop, is long and crosses the tortuous RHA to reach the gallbladder. When the CA arises from a distal loop, it is very short, this variant being the most common [2] , [6] , [10] , [11] , [15] , [16] , [17] . In our case, the hump had a single loop with a short CA arising from its convexity.…”

Section: Discussionmentioning

confidence: 99%

Moynihan's Lump as an unusual variant of right hepatic artery during a laparoscopic cholecystectomy approach. A case report

Martín-Pérez

Rodríguez

Cruz

et al. 2021

International Journal of Surgery Case Reports

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Introduction and importance One of the most important measures during the cholecystectomy procedure is based on a “Culture for Safe Cholecystectomy (CSC)”. Vascular injury reports an open surgery conversion rate of 0 to 1.9% and a mortality of less than 0.02%. The caterpillar or Moynihan's hump configuration is characterized by a tortuous right hepatic artery (RHA) running proximal and/or parallel to the cystic duct and predisposes to a small and/or short cystic artery (CA). Case presentation A 65-year-old woman with no relevant clinical history underwent a laparoscopic cholecystectomy (LC) for cholelithiasis; during the procedure a caterpillar or Moynihan's hump was identified. Clinical discussion Anatomical variations represent 20-50% of all cases; therefore, CVS is required. The incidence of caterpillar or Moynihan's hump varies between 1% and 13% of all cases. To date, the scientific literature on this topic is limited. The most accepted etiology is related to embryological formation. Conclusion Biliary and arterial variations are more frequent than we think, so an anatomical knowledge, CSC and CVS represent a fundamental rule, increasing the safety of the surgical procedure.

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Moynihan’s hump of the right hepatic artery in Calot’s triangle: a systematic review and meta-analysis of its incidence and surgical importance

et al. 2023

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Moynihan’s Hump: Our Eyes See What Our Mind Knows

Cited by 5 publications

References 5 publications

A 56-Year-Old Woman with Acute Cholecystitis and a Moynihan’s Hump, or Caterpillar Configuration, of the Right Hepatic Artery Identified During Laparoscopic Cholecystectomy

A 56-Year-Old Woman with Acute Cholecystitis and a Moynihan’s Hump, or Caterpillar Configuration, of the Right Hepatic Artery Identified During Laparoscopic Cholecystectomy

Moynihan's Lump as an unusual variant of right hepatic artery during a laparoscopic cholecystectomy approach. A case report

Moynihan’s hump of the right hepatic artery in Calot’s triangle: a systematic review and meta-analysis of its incidence and surgical importance

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