肠系膜上静脉外科干的观察

作者解剖和观察了83例成人尸体肠系膜上静脉外科干及其与下腔静脉和肠系膜上动脉的关系;测量了80例外科干的长度及其上、下端的宽度,及外科于上、下端与下腔静脉的间距。 发现①83例肠系膜上静脉中3例无外科干,5例外科干短于2cm。②18例外科干左侧有口径与其相等或几乎相等的粗大的小肠静脉。③33例外科干的前、后方有肠系膜上动脉分支越过。④多数肠系膜上动、静脉相并行且动脉居静脉左侧。完全或基本符合肠腔分流术条件的外科干共59例占71.08±4.97％。     

Henle干和外科干的解剖观察及临床意义

目的 :为肠腔分流术提供Henle干和外科干的解剖学资料。方法 :用常规解剖学方法观察与测量了成人尸体Henle干的合成、类型、长度和肠系膜上静脉外科干的长度、外径以及其他相关资料。结果 :Henle干的合成以胃结肠干为主 ,占 74 .0 % ,外科干的长度约为 3.88cm ,Henle干汇入外科干的角度约为 115 .0°,回结肠静脉汇入外科干的角度约为 14 0 .0° ,Henle干与十二指肠下曲的距离约为 2 .70cm ,外科干中点与下腔静脉间距约为 2 .37cm。结论 :适于进行肠腔分流术的外科干占 6 0 .9% ,尤以上界为Henle干的外科干较宜进行肠腔分流术。     

肠系膜下静脉－腔静脉分流术

肠系膜下静脉－腔静脉分流术重庆第三军医大学西南医院肝胆外科中心报告了采用肠系膜下静脉－腔静脉分流术合用脾切除、胃底贲门周围血管离断术治疗１６例肝炎后肝硬变门静脉高压症的经验。肠系膜下静脉－腔静脉吻合口直径平均为６．４６±０．７８ｍｍ，分流后ＦＰＰ平均...     

肠系膜上、下动脉选择性造影的应用解剖学

为提供与选择性肠系膜上、下动脉造影插管有关的应用解剖学资料,在40具成人尸上,对肠系膜上、下动脉及其分支进行了观测,并讨论了与临床应用有关的问题。     

膈下动脉、肾下腺中动脉起源异常一例

<正> 本例为左右膈下动脉及肾上腺中动脉起自腹主动脉的分支——腹腔动脉。1.膈下动脉干:从腹腔干发出后向右上方行进,在距根部1.0mm处发出左肾上腺上动脉,再行进8.0mm发出右肾上腺上动脉。然后在膈肌腔静脉孔右后方分为左膈     

左结肠动脉发自肠系膜上动脉变异一例

一般情况下,左结肠动脉单独或与乙状结肠动脉共干发自肠系膜下动脉.我们在解剖一具老年男性尸体时,未见肠系膜下动脉发出分支到降结肠.而在清理肠系膜上动脉的分支时,发现有一动脉在胰腺下缘处自肠系膜上动脉(直径7.86mm)发出.发出后,经腹膜壁层的后方横行向左,至降结肠附近分为升、降2支.升支与中结肠动脉的左支吻合,降支与和乙状结肠动脉的升支吻合.该动脉起始处外径3.18mm,全长14.30cm.     

肠系膜上静脉外科干的解剖学研究

<正> 用外科手术治疗门脉高压症的方法很多。近三十年来,门腔分流术和肠腔分流术的术式有了很大的发展。1964年,Gillot~1对肠系膜上静脉进行了详细的解剖,并将静脉可供吻合的一段称为外科干。对肠系膜上静脉外科干(以下简称外科干)及周围结构的了解,是直接关系到肠腔分流术的成败,目前虽有报导~(2-7),但有些例数过少,有些资料不全。本文的目的是提供肠系膜上静脉外科干的解剖学资料,为肠腔分流术提供必要的形态学依据。     

双侧肾动脉伴右睾丸动脉变异1例

正在解剖一具身长135 cm的男童尸体时发现双侧肾动脉均有多支,同时伴有右侧睾丸动脉起始点变异(图1),现报道如下。右肾动脉共有3支,均发自腹主动脉右侧壁。上支距肠系膜上动脉根部右下方1.25 cm处发出,外径3.3 mm,血管干长3.2 cm,走在下腔静脉的下方,于腰大肌前方行向肾门,进入肾中上段。中支距上支下缘2.55 cm处发出,外径为2.2mm,血管干长3.3 cm,走行在下腔静脉的上方、输尿管的下方斜向外下方进入肾下段。下支起点较低,距肠系膜下动脉起始处右下方1.1 cm处发出,外径2.3 mm,血管干长4.15 cm,走     

下腔静脉变异一例报导

例一:成年男尸、肾下段双重下腔静脉(图1),左下腔静脉由左髂内、髂外静脉在第五腰椎体的下1/3处,脊柱的左前方,髂内动脉的背侧汇合而成,此静脉先位于髂内,髂总动脉的背侧,继沿腹主动脉的左侧上升,至平第一腰椎体处横行折向右侧,经肠系膜上动脉起始处的下方,腹主动脉之前到其右侧,与右下腔静脉汇合,左下腔静脉     

肠腔静脉分流术及“H”形架桥术有关的解剖学数据

自从Clafworthy(1955)首先报导肠系膜上静脉与下腔静脉端侧吻合术以来,相继出现肠腔静脉侧侧吻合术和肠腔静脉架桥术等不同分流术式。为提供肠腔静脉吻合术及自体血管     

下腔静脉的应用解剖观察

在30具成人尸体上解剖观察了①下腔静脉的起点、各段的外径长度、各段前后方动静脉跨过的情况。②特别是第三段(腔静脉窝段)的形态变化和肝静脉开口的情况。对肝外科手术及超声波检查提供了资料。     

树鼩肝移植的解剖基础

目的　为树鼩肝移植的开展提供解剖学基础。 方法　解剖12只成年树鼩观察肝脏形态、毗邻及主要血管、胆管的走形和分布,并在解剖基础上探讨和对3组树鼩采用“双袖套管法”行肝移植术。 结果　树鼩肝动脉直径（0.63±0.21）mm,均发自腹腔干;肝上下腔静脉距横膈（5.35±0.55）mm,直径（6.86±0.61）mm;肝下下腔静脉直径（5.28±0.58）mm;肝门静脉由肠系膜上静脉及脾静脉汇成,直径（3.86±　0.57）mm;胆总管由胆囊管及肝总管汇成,长度（15.5±2.6)mm;直径(0.75±0.12)mm。3组树鼩顺利行肝移植术操作,术后存活时间为3h、5h和6h。 结论　树鼩在解剖学基础上建立肝移植模型具有一定的可行性。     

The hepatic veins: Anatomy and classification on single slice spiral CT in North Indian population

AimsTo find out the normal pattern of hepatic veins in the North Indian population and to categorize them.MethodsThe present study was conducted on 100 patients whose spiral CT abdomen was performed for various medical conditions in the department of radiodiagnosis.ResultsFour categories were recognized. Category-1, when right hepatic vein drains independently into the inferior vena cava whereas middle and left hepatic veins join together to form a common trunk before draining into the inferior vena cava. It was observed in 74% patients. Category-2 was observed in 2% patients, where right & middle hepatic veins join to form a common trunk and left hepatic vein drain independently into the inferior vena cava. Category-3 was observed in 21% patients, where all the three major hepatic veins drain independently into the inferior vena cava. Category-4 was observed in 3% patients, where all the three major hepatic veins join together to form a common trunk before draining into the inferior vena cava.ConclusionsCategory-1 is the most common pattern of major hepatic vein drainage found in the North Indian population. The present study also concluded that single right, middle and left hepatic vein is the most common pattern of hepatic veins present in the North Indian population. Caudate lobe is drained by more than one vein in majority of North Indians. Also superomedial vein, right accessory vein and inferior right hepatic vein are the most common accessory veins present in the North Indian population.     

64层螺旋CT三维重建活体肝静脉的研究及临床意义

目的:探讨64层螺旋CT应用于正常人活体体肝静脉研究的可行性,观察三维重建肝静脉的一般形态及走行规律.方法:153例正常受试者经肘正中静脉注射造影剂后,使用64层螺旋CT进行上腹部扫描,图像采集后经容积再现(volume rendering,VR)技术重建肝静脉.结果:重建图像清晰,可显示出6～8级血管及与周围组织间的关系.其中153例肝静脉的分型结果如下:①3分支型,占35.3%(54例);②中左共干型,占41.8%(64例);③中左合干型,占20.9%(32例);④中右共干型,占2.0%(3例).结论:64层螺旋CT可以作为研究活体肝静脉形态的有效手段,三维重建能更准确、全方位地显示肝静脉的正常解剖类型和发现变异,而且图像清晰,对于活体肝静脉的研究有较好的临床应用价值.     

Duplication of the inferior vena cava associated with other variations

Multiple vascular variations, including duplication of the inferior vena cava, double renal arteries and anomalies of the testicular blood vessels, were observed during dissection of the retroperitoneal region of a cadaver of an 87-year-old Japanese man. The right inferior vena cava arose from the union of right common iliac veins and a thinner interiliac vein. This interiliac vein ascended obliquely from right to left and joined the left common iliac veins to form the left inferior vena cava. The right and left inferior venae cavae were of approximately equal width. The right testicular vein consisted of medial and lateral venous trunks. The two venous trunks coalesced to form a single vein, which drained into the confluence of the right inferior vena cava and right renal vein. The left testicular vein was composed of the medial and lateral testicular veins, which drained into the left renal vein. Double renal arteries were seen bilaterally, which originated from the lateral aspects of the abdominal aorta. The right testicular artery arose from the right inferior renal artery and accompanied the lateral trunk of the right testicular vein running downwards. The left testicular artery arose from the ipsilateral inferior renal artery and ran downwards accompanied by the left lateral testicular vein. In addition, the bilateral kidneys showed multicystic changes.     

ATYPICAL POLYSPLENIA ONLY WITH ABSENCE OF THE HEPATIC SEGMENT OF INFERIORVENA CAVA IN A MIDDLE-AGED

An autopsy case of polysplenia with absence of the hepatic segment of the inferior vena cava in a 53-year-old female is reported. The venous blood from the lower parts of the body was drained through the azygos vein and the superior vena cava into the right atrium. Other than acquired pathological change, the heart was found to be normal. Except for the partial absence of the inferior vena cava, isomerism of asymmetric organs, and heterotaxia of abdominal organs, characteristic of typical polysplenia, were not present. This case of atypical polysplenia suggests the presence of a transitional form in the complex.     

Focal nodular hyperplasia of the liver associated with portal vein agenesis: a morphological and immunohistochemical study of one case and review of the literature

Congenital absence of portal vein (CAPV) is a rare malformation. To our knowledge, sixteen cases are reported in western literature. All the cases are associated with other diseases, cardiac malformations (12/17 patients; 16 plus the present case) and hepatic neoplasms being the most frequent observations. We present the case of a girl with a complex malformative syndrome consisting of multicystic kidney dysplasia, CAPV and nodular tumor-like mass of the liver. Angiography showed that the splenic vein and superior mesenteric vein joined to form a common trunk directly entering the inferior vena cava above the liver. A review of the CAPV cases of the literature and the clinical and pathological features of the hepatic lesion, classified as Focal Nodular Hyperplasia (FNH), are extensively discussed.     

国人肝段在冠状断层上的划分

目的：为肝内微小病变精确定位诊断和外科治疗提供冠状断层解剖学依据。方法：采用30例上腹部连续冠状断层标本、20例肝内门静脉和肝静脉解剖正常的薄层MSCT断层图像及其三维重建图像,在冠状断层上对其门静脉肝段进行精确划分。结果：经胆囊、门静脉左支及肝左静脉的冠状断面上,肝中静脉主干是划分右前上叶和左前下叶的识别标志,门静脉左支角部是左前下叶的段间裂识别标志,亦是右前上叶和左前下叶的亚段间裂识别标志。经肝门静脉主干的冠状断面上,门静脉右前支主干是右前上叶的段间裂识别标志,该层面以前为右前上叶的腹侧段,该层面以后则为右前上叶的背侧段。经网膜孔的冠状断面上、下腔静脉的右缘是划分尾状叶和右半肝的识别标志,门静脉右后支主干是划分右前上叶背侧段和右后下叶下段的标志,经下腔静脉和肝右静脉的冠状面上,肝右静脉主干是划分右前上叶的背侧段和右后下叶上段的标志;门静脉右后支主干是右后下叶的段间裂识别标志。结论：国人门静脉肝段在冠状断面上的精确划分,不仅有利于肝内微小病变的精确定位,且有利于探索新的和更加安全的外科术式。     

胃裸区的冠状断层解剖学研究

目的：为给胃底部和食管腹段疾病的现代影像学诊断和外科治疗提供实用的形态学依据。方法：用成人躯干部连续冠状断层标本30例,研究了胃裸区在连续冠状断层上的典型表现及胃裸区内的结构。结果：（1）胃膈韧带右层与小网膜的后层相续,左层与膈脾韧带右层及胃脾韧带后层相续,向下左、右层靠拢而续为胃胰襞左部。在冠状断层上寻找胃裸区的最佳层面在A11（下腔静脉前份层面（和A12（下腔静脉中份层）。（2）胃裸区居胃膈韧带的左、右层之间,其存在率为100％。胃裸区内除有迷走神经后干,血管、淋巴结外,左肾上腺、左肾上极及胰体上份亦可进入其内。结论：（1）胃为腹膜间位器官。（2）国膈韧带很短且两层间的距离较宽,加上胃裸区较大,胃底后壁的活动度较小,在施行胃底和食管腹段手术构解胃底后壁时,对胃裸区内的结构应给与足够的重视。     

Duplicate testicular veins accompanied by anomalies of the testicular arteries.

Duplicate testicular veins associated with other anomalies of the testicular arteries were observed during dissection of the posterior abdominal wall in a 90-year-old Japanese male cadaver. The right testicular vein was composed of the medial and lateral testicular veins. The medial testicular vein drained into the inferior vena cava, whereas the lateral testicular vein drained into the confluence of the inferior vena cava and right renal vein. Several anastomosing branches were seen between the medial and lateral testicular veins. The left testicular vein was formed after the medial and lateral venous trunks joined and drained into the ipsilateral renal vein. The right testicular artery originated from the anterior surface of the abdominal aorta at the level of the left renal artery, passed posterior to the inferior vena cava, and accompanied the right lateral testicular vein running downwards. The left testicular artery arose from the abdominal aorta at a level of 5 cm below the origin of the right testicular artery, and then ran downwards accompanied by the medial trunk of the left testicular vein.