Original Article MORPHOMETRIC ANALYSIS and MUCIN
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A New Insight Into the Morphology of the Human Liver: a Cadaveric Study
Hindawi Publishing Corporation ISRN Anatomy Volume 2013, Article ID 689564, 6 pages http://dx.doi.org/10.5402/2013/689564 Research Article A New Insight into the Morphology of the Human Liver: A Cadaveric Study Sunitha Vinnakota1 and Neelee Jayasree2 1 Maharajah’s Institute of Medical Sciences, Nellimarla, Vizianagaram District, Andhra Pradesh 535217, India 2 Narayana Medical College, Chintareddy Palem, Nellore, Andhra Pradesh 524003, India Correspondence should be addressed to Sunitha Vinnakota; [email protected] Received 3 October 2013; Accepted 12 November 2013 Academic Editors: C. Casteleyn, M. C. Killingsworth, and M. Nakamura Copyright © 2013 S. Vinnakota and N. Jayasree. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Day to day advances in the fields of radiology like sonography and CT need to revive interest in the cadaveric study of morphological features of liver, as the accessory fissures are a potential source of diagnostic errors. Accessory fissures vary from single to multiple over different parts of the liver. Aim. In the present study the morphological features of human liver specimens were evaluated by macroscopic examination and morphometric analysis. Methods. The study was conducted on 58 specimens obtained from cadavers utilized for routine dissection for medical undergraduates from the year 2004 to 2012 in the Anatomy Department of MIMS Medical College. Results. In the present study the livers as described in the established anatomical literature with normal surfaces, fissures, and borders were considered normal. Out of the 58 specimens, 24 were normal without any accessory fissures or lobes and with normal contours. -
Papilla with Separate Bile and Pancreatic Duct Orifices
JOP. J Pancreas (Online) 2013 May 10; 14(3):302-303. MULTIMEDIA ARTICLE – Clinical Imaging Papilla with Separate Bile and Pancreatic Duct Orifices Surinder Singh Rana, Deepak Kumar Bhasin Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER). Chandigarh, India A 32-year-old male, a known case of alcohol related Conflict of interest The authors have no potential chronic non calcific pancreatitis, was referred to us for conflicts of interest pancreatic endotherapy for relief of intractable abdominal pain. The cross sectional imaging studies References had revealed an irregularly dilated main pancreatic duct. The examination of the major duodenal papilla 1. Silvis SE, Vennes JA, Dreyer M. Variation in the normal duodenal papilla. Gastrointest Endosc 1983; 29:132-133 [PMID; revealed the presence of two separate orifices at 6852473] endoscopic retrograde cholangiopancreatography (ERCP) (Image). The cranial orifice was located at 11- 12 clock position whereas the caudal orifice was located at 4-5 clock position. The caudal orifice was selectively cannulated and the injection of the contrast revealed presence of an irregularly dilated main pancreatic duct. The cannula and the guide wire introduced through the caudal orifice selectively entered the pancreatic duct and did not come out through the cranial orifice. During ERCP, bile could be seen coming out of the cranial orifice, confirming it to be the orifice of common bile duct. Following selective cannulation of the main pancreatic duct, a 5-Fr stent was placed into the pancreatic duct. Following this, the patient had complete pain relief and is planned for further sessions of pancreatic endotherapy along with pancreatic sphincterotomy. -
Variation of Cystic Duct Insertion in Relation to the Extrahepatic Ducts
AbeshaAmbaye et al. / International Journal of Pharma Sciences and Research (IJPSR) Variation of Cystic Duct Insertion in Relation to the Extrahepatic Ducts and Observed Frequency of Double Lumen Apparent Common Bile Duct AbeshaAmbaye1, MueezAbraha2,Bernard A. Anderson2, Amanuel T. Tsegay1 Anatomy Course and Research Team, Institute of Biomedical Sciences, College of Health Sciences, Mekelle University Dep’t of Anatomy, College of Medicine and Health Sciences, University of Gondar, Ethiopia email [email protected] ABSTRACT Background: Variations in the pattern of the extra hepatic biliary tract are common and usually encountered during radiological investigations or during operations on the biliary tree. Having a good knowledge of the possible connections of the cystic duct with the common hepatic duct to form the common bile duct is very important; because variation in this area is common. Objectives: The main aim of this study is to evaluate the frequency of anatomic variations of the cystic duct insertion in relation to the extrahepatic ducts and Observed Frequency of Double Lumen Apparent Common Bile Duct Methods: Institutional based cross-sectional study design with observational data collection tool was conducted in 25 Ethiopian fixed cadavers and Forensic autopsy specimens obtained from Departments of Human Anatomy at University of Gondar, Mekelle and St. Paul Hospital Millennium Medical College Result: From the total 25 specimens dissected 9 (36%) had the ACBD and the 16 (64%) of them had CBD with one lumen. Conclusion: The billiary system formation is very variable, among the variants; the number of the supradoudenal insertion is greater than the infradoudenal insertion. ACBD is more frequent than expected which is 36% of the total data. -
Fact Sheet - Symptoms of Pancreatic Cancer
Fact Sheet - Symptoms of Pancreatic Cancer Diagnosis Pancreatic cancer is often difficult to diagnose, because the pancreas lies deep in the abdomen, behind the stomach, so tumors are not felt during a physical exam. Pancreatic cancer is often called the “silent” cancer because the tumor can grow for many years before it causes pressure, pain, or other signs of illness. When symptoms do appear, they can vary depending on the size of the tumor and where it is located on the pancreas. For these reasons, the symptoms of pancreatic cancer are seldom recognized until the cancer has progressed to an advanced stage and often spread to other areas of the body. General Symptoms Pain The first symptom of pancreatic cancer is often pain, because the tumors invade nerve clusters. Pain can be felt in the stomach area and/or in the back. The pain is generally worse after eating and when lying down, and is sometimes relieved by bending forward. Pain is more common in cancers of the body and tail of the pancreas. The abdomen may also be generally tender or painful if the liver, pancreas or gall bladder are inflamed or enlarged. It is important to keep in mind that there are many other causes of abdominal and back pain! Jaundice More than half of pancreatic cancer sufferers have jaundice, a yellowing of the skin and whites of the eyes. Jaundice is caused by a build-up bilirubin, a substance which is made in the liver and a component of bile. Bilirubin contains a lot of yellow pigment, and gives bile it’s color. -
Common Bile Duct Exploration
Education Common Bile Duct Exploration What is a common bile duct exploration? The common bile duct is a tube that connects the liver, gallbladder, and pancreas to the small intestine. It helps deliver fluids for digestion. A common bile duct exploration is a procedure used to see if a stone is blocking the flow of bile from your liver and gallbladder to your intestine. When is it used? When a stone gets stuck in the common bile duct it may cause bile to back up into the liver. This causes jaundice. Jaundice is a condition in which the skin and the whites of the eyes become yellowish. If the stone is not removed, the common bile duct may become infected and need emergency surgery. It can also cause pancreatitis, a reaction in the pancreas that can be life threatening. Common bile duct exploration is often done during surgery to remove the gallbladder. An alternative procedure is an endoscopic retrograde cholangiopancreatography (ERCP). When an ERCP is done, a tube is inserted through your mouth and stomach into the small intestine. The tube can be used to put contrast dye into the duct to look for stones with x-rays. If there are stones, a small opening is made in the common duct to allow the stone or stones to pass into the intestine. You should ask your health care provider about these choices. How do I prepare for a common bile duct exploration? Plan for your care and recovery after the operation. Allow for time to rest and try to find people to help you with your day-to- day duties. -
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Mft•] ~;;I~ [I) I~ t?l3 ·ilr!f·S; [,j ~ M Hepatobiliary Imaging Update Maggie Chester and Jerry Glowniak Veterans Affairs Medical Center and Oregon Health Sciences University, Portland, Oregon and the gallbladder ejection fraction (EF) after the injection This is the first article in a four-part series on interventional of cholecystokinin (CCK) (Kinevac®, Squibb Diagnostics, nuclear medicine. Upon completion, the nuclear medicine New Brunswick, NJ). A brief description of the hepatic ex technologist should be able to (1) list the advantages of using traction fraction (HEF) was given; the technique used quan interventional hepatic imaging, (2) identify the benefit in tifies hepatocyte function more accurately than does excretion calculating HEF, and (3) utilize the HEF calculation method when appropriate. half-time. Since publication of the previous article (5), the HEF has become more widely used as a measure of hepatocyte function, and nearly all the major nuclear medicine software vendors include programs for calculating the HEF. Scintigraphic assessment of hepatobiliary function began in In this article, we will describe new observations and meth the 1950s with the introduction of iodine-131 C31 1) Rose ods used in hepatobiliary imaging. The following topics will bengal (1). Due to the poor imaging characteristics of 1311, be discussed: ( 1) the use of morphine as an aid in the diagnosis numerous attempts were made to find a technetium-99m 99 of acute cholecystitis, (2) the rim sign in the diagnosis of acute ( mTc) labeled hepatobiliary agent (2). The most useful of cholecystitis, and (3) methods for calculating the HEF. the several 99mTc-labeled agents that were investigated were the iminodiacetic acid (IDA) analogs, which were introduced MORPHINE-AUGMENTED CHOLESCINTIGRAPHY in the mid 1970s (3). -
Mistakes in Pancreatobiliary Imaging and How to Avoid Them
ueg education Mistakes in… 2020 Mistakes in pancreatobiliary imaging and how to avoid them Marianna Arvanitakis and Martina Pezzullo Multidetector computed tomography (CT) and magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP) are cross-sectional imaging modalities largely used for patients with pancreatobiliary diseases.1–3 Despite recent technological advances, correct use and interpretation of related radiological findings require good clinical judgment and collaboration between gastroenterologists and radiologists. In this article, we highlight mistakes frequently made during the radiological investigation and interpretation of findings in patients with suspected pancreatobiliary diseases, based on the available literature and on our clinical experience. There are several biliary anatomic variations to Mistake 1 Not describing or looking for a b anatomical variants be aware of that may lead to perioperative biliary injury: perihilar insertion of the cystic duct defined Laparoscopic cholecystectomy is currently as a short cystic duct with an insertion <1 cm from the standard procedure for treatment of the hilum; posterior insertion of the cystic duct symptomatic gallstone disease.4 Bile duct injury into the common bile duct (CBD); direct insertion can occur during the procedure with an incidence of a segmental/sectoral right hepatic duct into the up to 0.7% and, albeit rare, can be associated Figure 1 | Imaging the cystic duct. a | 2D MRCP gallbladder or the cystic duct; and insertion of a with significant morbidity and even mortality.4 showing that what looks like the cystic duct (arrow) is right sectoral/segmental hepatic duct directly into Biliary anatomical variations can lead to actually the right posterior duct separately originating the CBD (figure 1).3,5 from the common bile duct. -
Bile Duct Cancer Causes, Risk Factors, and Prevention Risk Factors
cancer.org | 1.800.227.2345 Bile Duct Cancer Causes, Risk Factors, and Prevention Risk Factors A risk factor is anything that affects your chance of getting a disease such as cancer. Learn more about the risk factors for bile duct cancer. ● Bile Duct Risk Factors ● What Causes Bile Duct Cancer? Prevention There's no way to completely prevent cancer. But there are things you can do that might help lower your risk. Learn more. ● Can Bile Duct Cancer Be Prevented? Bile Duct Risk Factors A risk factor is anything that affects your chance of getting a disease like cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person’s age or family history, can’t be changed. But having a risk factor, or even many risk factors, does not mean that a person will get 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 the disease. And many people who get the disease have few or no known risk factors. Researchers have found some risk factors that make a person more likely to develop bile duct cancer. Certain diseases of the liver or bile ducts People who have chronic (long-standing) inflammation of the bile ducts have an increased risk of developing bile duct cancer. Certain conditions of the liver or bile ducts can cause this, these include: ● Primary sclerosing cholangitis (PSC), a condition in which inflammation of the bile ducts (cholangitis) leads to the formation of scar tissue (sclerosis). People with PSC have an increased risk of bile duct cancer. -
Nomina Histologica Veterinaria, First Edition
NOMINA HISTOLOGICA VETERINARIA Submitted by the International Committee on Veterinary Histological Nomenclature (ICVHN) to the World Association of Veterinary Anatomists Published on the website of the World Association of Veterinary Anatomists www.wava-amav.org 2017 CONTENTS Introduction i Principles of term construction in N.H.V. iii Cytologia – Cytology 1 Textus epithelialis – Epithelial tissue 10 Textus connectivus – Connective tissue 13 Sanguis et Lympha – Blood and Lymph 17 Textus muscularis – Muscle tissue 19 Textus nervosus – Nerve tissue 20 Splanchnologia – Viscera 23 Systema digestorium – Digestive system 24 Systema respiratorium – Respiratory system 32 Systema urinarium – Urinary system 35 Organa genitalia masculina – Male genital system 38 Organa genitalia feminina – Female genital system 42 Systema endocrinum – Endocrine system 45 Systema cardiovasculare et lymphaticum [Angiologia] – Cardiovascular and lymphatic system 47 Systema nervosum – Nervous system 52 Receptores sensorii et Organa sensuum – Sensory receptors and Sense organs 58 Integumentum – Integument 64 INTRODUCTION The preparations leading to the publication of the present first edition of the Nomina Histologica Veterinaria has a long history spanning more than 50 years. Under the auspices of the World Association of Veterinary Anatomists (W.A.V.A.), the International Committee on Veterinary Anatomical Nomenclature (I.C.V.A.N.) appointed in Giessen, 1965, a Subcommittee on Histology and Embryology which started a working relation with the Subcommittee on Histology of the former International Anatomical Nomenclature Committee. In Mexico City, 1971, this Subcommittee presented a document entitled Nomina Histologica Veterinaria: A Working Draft as a basis for the continued work of the newly-appointed Subcommittee on Histological Nomenclature. This resulted in the editing of the Nomina Histologica Veterinaria: A Working Draft II (Toulouse, 1974), followed by preparations for publication of a Nomina Histologica Veterinaria. -
Anatomy of the Digestive System
The Digestive System Anatomy of the Digestive System We need food for cellular utilization: organs of digestive system form essentially a long !nutrients as building blocks for synthesis continuous tube open at both ends !sugars, etc to break down for energy ! alimentary canal (gastrointestinal tract) most food that we eat cannot be directly used by the mouth!pharynx!esophagus!stomach! body small intestine!large intestine !too large and complex to be absorbed attached to this tube are assorted accessory organs and structures that aid in the digestive processes !chemical composition must be modified to be useable by cells salivary glands teeth digestive system functions to altered the chemical and liver physical composition of food so that it can be gall bladder absorbed and used by the body; ie pancreas mesenteries Functions of Digestive System: The GI tract (digestive system) is located mainly in 1. physical and chemical digestion abdominopelvic cavity 2. absorption surrounded by serous membrane = visceral peritoneum 3. collect & eliminate nonuseable components of food this serous membrane is continuous with parietal peritoneum and extends between digestive organs as mesenteries ! hold organs in place, prevent tangling Human Anatomy & Physiology: Digestive System; Ziser Lecture Notes, 2014.4 1 Human Anatomy & Physiology: Digestive System; Ziser Lecture Notes, 2014.4 2 is suspended from rear of soft palate The wall of the alimentary canal consists of 4 layers: blocks nasal passages when swallowing outer serosa: tongue visceral peritoneum, -
Falciform Ligament
It is largest gland in body, soft & pliable . Location: RT hypochondrium just beneath diaphragm which separates from the liver from thoracic cavity. Surfaces of liver: Superioanterior surface (diaphragmatic): its a convex upper surface of liver is molded to domes of diaphragm. Posteroinferior (visceral) :its irregular in shape molded to adjacent viscera 1)Large RT lobe & small LT lobe form by attachment of peritoneum of falciform ligament . 2)RT lobe is further subdivided into a quadrate lobe & caudate lobe by presence of gallbladder , ligamentum teres, inferior vena cava & ligamentum venosum . It found on visceral surface & lies between caudate & quadrate lobes . It containes : RT & LT hepatic ducts. RT& LT branches of hepatic artery. Portal vein. Sympathetic & parasympathetic nerve fibers . Hepatic lymph nodes. Peritoneal relation: Falciform Ligament: which is two-layered fold of peritoneum ascends from umbilicus to liver. It contain ligamentum teres ( remains of umbilical vein). Falciform ligament passes on to anterior & then superior surfaces of liver& then splits into two layers. The right upper layer forms coronary ligament. left upper layer of falciform ligament forms left triangular ligament . The right extremity of coronary ligament is known as right triangular ligament. ligamentum venosum ( remains of the ductus venosus) a fibrous band is attached to left branch of portal vein and inferior vena cava. lesser omentum arises from lesser curvature of stomach till edges of porta hepatis. It be noted that the peritoneal layers forming the coronary ligament are widely separated leaving an area of liver devoid of peritoneum. Diaphragm. RT & LT costal margins. RT & LT pleura . Lower margins of both lungs. Xiphoid process. -
Surgical Significance of Variations in Anatomy in the Biliary Region
International Journal of Research in Medical Sciences Hassan AU et al. Int J Res Med Sci. 2013 Aug;1(3):xx-xx www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 DOI: 10.5455/2320-6012.ijrms20130812 Review Article Surgical significance of variations in anatomy in the biliary region Ashfaq Ul Hassan1*, Showqat A. Zargar2, Aijaz Malik3, Pervez Shah4 1Department of Anatomy, SKIMS Medical College, Srinagar, Kashmir, India 2Department of Gastroenterology, SKIMS, Srinagar, Kashmir, India 3Department of Surgery, SKIMS, Srinagar, Kashmir, India 4Department of Medicine, SMHS Hospital, Srinagar, Kashmir, India Received: 8 May 2013 Accepted: 21 May 2013 *Correspondence: Dr. Ashfaq Ul Hassan, E-mail: [email protected] © 2013 Hassan AU et al. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Variations in the anatomy of the gallbladder, the bile ducts, and the arteries that supply them and the liver are important to the surgeon, because failure to recognize them can cause iatrogenic injury to the biliary tract. A surgeon should be always be careful while operating in this area. In addition these anomalies are associated with a range of other congenital anomalies, including biliary atresia and cardiovascular or other gastrointestinal malformations, biliary lithiasis, choledochal cyst, anomalous pancreaticobiliary junction etc, so a look out for other anomalies should be carried out simultaneously. Keywords: Gall bladder, Cystic fossa, Calots triangle, Monyhans hump, Extrahepatic, Atresia, Double Gall bladder, Triple Gall bladder, Agenesis, Cystic duct, Carolis disease NORMAL ANATOMY the left from the neck of the gallbladder, and joins the common hepatic duct to form the common bile duct.