变异肝动脉的解剖学特点及其临床意义

目的　观察变异肝动脉的解剖学特点,为临床相关血管影像学检查、手术及介入治疗等提供形态学资料。 方法　按常规方法解剖25例成人尸体标本,沿肝总动脉追踪、寻找肝固有动脉的分支并观察分布情况。 结果　本组肝固有动脉及其分支变异率为28%。其中有2例属Hitta分型外的变异肝动脉,肝固有动脉右侧壁未见胃右动脉,而是在左侧壁发出1支动脉主干,远端分支分布于肝和胃,本文称为“肝胃动脉（HGA）”;其中标本2从HGA主干后壁发出1分支,远端也分布于肝和胃,本文称为“肝胃副动脉”。 结论　本组2例起于肝固有动脉左侧壁的HGA,是胃小弯右侧的主要动脉来源,并有分支营养肝和胃的其他部位。此种变异补充了变异肝动脉的形态学资料,对临床有一定的指导价值。     

变异肝动脉的解剖学特点及其临床意义

目的　观察变异肝动脉的解剖学特点，为临床相关血管影像学检查、手术及介入治疗等提供形态学资料。 方法　按常规方法解剖25例成人尸体标本，沿肝总动脉追踪、寻找肝固有动脉的分支并观察分布情况。 结果　本组肝固有动脉及其分支变异率为28%。其中有2例属Hitta分型外的变异肝动脉，肝固有动脉右侧壁未见胃右动脉，而是在左侧壁发出1支动脉主干，远端分支分布于肝和胃，本文称为“肝胃动脉（HGA）”；其中标本2从HGA主干后壁发出1分支，远端也分布于肝和胃，本文称为“肝胃副动脉”。 结论　本组2例起于肝固有动脉左侧壁的HGA，是胃小弯右侧的主要动脉来源，并有分支营养肝和胃的其他部位。此种变异补充了变异肝动脉的形态学资料，对临床有一定的指导价值。     

肝总动脉分支变异1例

肝固有动脉起点变异的情况临床比较常见，多见于肝固有动脉与胃左动脉共干或肝固有动脉起自于肠系膜上动脉，或有起源不同的两支肝固有动脉。作者应用解剖制作标本过程中发现一例肝总动脉末端呈三叉型发出肝左动脉、肝右动脉和胃十二指肠动脉，并无肝固有动脉，同时肝左动脉在近起点处发出细小肝副左动脉与肝左动脉平行进入肝左叶。     

腹腔干缺如和脾动脉异位起源于肠系膜上动脉一例

笔者在解剖1具成年男性尸体时,发现其腹腔干缺如,肝总动脉分支及肠系膜上动脉分支发生变异,为积累资料及为临床提供参考,报道如下. 肝总动脉外径3.75 mm,在第12胸椎体前方由腹主动脉前壁发出,分为胃左动脉、肝固有动脉、胃十二指肠动脉.肝固有动脉沿下腔静脉左前方上行,在距离肝总动脉起始点4.39 cm处发出胃左动脉(外径2.41 mm),之后胃左动脉继续向左行走至胃小弯.肝固有动脉分出肝左动脉和肝右动脉.肝左动脉直接进入肝左叶,肝右动脉入肝前发出胆囊动脉.     

双肝固有动脉变异1例

正在局部解剖学教学中,发现1例成年女性尸体双侧肝固有动脉合并胆囊动脉起点变异,现报道如下。标本的肝总动脉先后从左向右发出左肝固有动脉和右肝固有动脉后转向右下方续为胃十二指肠动脉(图1)。肝总动脉自腹腔干根部出发点31.5 mm处发出左肝固有动脉,起始处直径10.1 mm。左肝固有动脉距其根部10.5 mm处发出左、中、右3个分支:左侧分支进入静脉韧带裂,起始处管径3.5 mm;     

肝总动脉及左膈下动脉来源变异一例

笔者在解剖1具50余岁男尸过程中,发现肝总动脉及左膈下动脉来源变异1例,为中国人体质调查积累数据和临床工作者提供参考,现报道如下. 肝总动脉在主动脉裂孔下方30 mm处直接起自腹主动脉,外径7.0 mm;肝总动脉沿肝下缘呈弓形向右走行18 mm后发出肝固有动脉和胃十二指肠动脉,肝固有动脉及胃十二指肠动脉走行正常.     

腹腔干分支变异一例

笔者在解剖1具成年男性尸体时,发现其腹腔干分支有较大变异,为积累资料及为临床提供参考,报道如下. 腹腔干外径5.63 mm,长2.50 cm,在第12胸椎体前方由腹主动脉前壁发出,分为脾动脉、胃左动脉、肝总动脉和变异肝固有动脉右支.其中脾动脉外径4.51 mm,胃左动脉外径3.06 mm,两者走行、分布与正常无异.变异肝固有动脉右支外径2.81 mm,从腹腔干发出后于肝门静脉和胆总管后面向右上方走行,在胆囊管与肝总管汇合处进入胆囊三角,然后沿肝总管右侧向上走行,经肝门右侧进入肝内.该动脉在距肝门1.00 cm处发出胆囊动脉,外径1.58mm.     

肝动脉分支分布变异1例

作者在解剖一老年男性尸体时，发现其肝动脉的分支分布变异，现报道如下：腹腔干发出3大分支，即脾动脉、肝总动脉和副左肝动脉。肝总动脉正常，距腹腔干1.85cm处发出肝固有动脉和胃右动脉，肝固有动脉又发出肝左、右地动脉。①副肝右动脉：起自胃右动脉，在距肝总动脉分支处0.24cm处发出，总长为4.6cm，跨过门静脉的前方，走行于胆总管的后方，随后分为两支进入肝右叶。     

肝固有动脉分支变异1例

肝固有动脉分支变异１例王珊①教学中在一老年男性标本上，发现其肝固有动脉终末分支有变异（附图），为积累资料，提供临床参考，现报道如下：肝固有动脉，在距肝总动脉起始处３．１ｃｍ处发出，外径３．５ｍｍ，长度１．１ｃｍ，其末端分为肝左动脉、胃右动脉和肝中动脉...     

三个不同来源肝固有动脉变异一例

<正> 在一具约35岁男性标本上,发现肝固有动脉存在三个不同的来源,简述如下: 肝固有动脉的左支,发自胃左动脉,在距离腹腔动脉分支处2.5厘米向上分出,长约6厘米,口径2.5毫米,在肝门左端进入肝左叶。该支并在自胃左动脉发出后上行约1.5厘米发出一食道支,至食道腹腔段;肝固有动脉中支,发自肝总动脉分为胃右动脉和胃     

颈总动脉及其分支与锁骨下动脉异常4例

<正>在教学中发现颈总动脉及其分支与锁骨下动脉走行异常。例1:中年男尸,右侧颈内动脉在起始处返折,呈横置的"U"字形,舌动脉与面动脉共干发自颈外动脉,舌动脉在面动脉的下方,先向后上再向前下螺旋走行,最后斜上走行,整体呈"V"字形。面动脉自舌动脉下方发出后绕经舌动脉的前面向后上方行走。颈总动脉上部和颈内动脉在颈动脉鞘内位于颈内静脉的前方(图1a)。颈总动脉中段与颈内静脉呈内外平行走行,颈总动脉下部位于颈内静脉后方,颈动脉小球位于颈外动脉后方(图1b)。     

Correspondence. Superficial brachial artery continuing as the common interosseous artery

The superficial artery of the arm with a course anterior to the median nerve is found at an incidence of ≈13%, and it continues as the radial artery twice as frequently than as the ulnar artery; less frequently it continues as both arteries (Bergman et al. 1988). We report a rare case in which the superficial brachial artery continued as the common interosseous artery only and the deep brachial artery continued as the radial and superficial ulnar arteries in the cubital fossa.     

Continuation of the ascending cervical artery as the occipital artery in man

We report an elderly male cadaver with unilateral anomalous continuation of the ascending cervical artery as the occipital artery. The ascending cervical artery was enlarged from its origin and supplied segmental branches through the intervertebral foramina. At the upper cervical spine, the ascending cervical artery continued as the occipital artery providing the branches normally seen stemming from this artery. No other vascular anomalies were noted in this specimen. This anatomical curiosity should be kept in mind by the clinician or academic who may manipulate this anatomical area.     

Coronary artery aneurysms and coronary artery fistula as a cause of angina pectoris

Coronary artery aneurysm is an uncommon disease. Coronary artery fistulae are infrequent congenital anomalies. A extremely rare case report of combination of coronary artery aneurysms and coronary artery fistula is presented with a brief literature review.     

睾丸动脉与肾上腺下动脉共干1例

作者上局部解剖学解剖一具成年男性尸体标本时,见其左侧睾丸动脉与肾上腺下动脉共干起始(如图1),现报道如下: 左侧睾丸动脉与肾上腺下动脉于距肾动脉起端平面下方1.5cm处共干起始于腹主动脉左外侧壁,起点外径约0.3cm.     

Spontaneous coronary artery dissection presenting as acute myocardial infarction

Spontaneous coronary artery dissection is a rare entity being increasingly diagnosed as a cause of acute myocardial infarction, especially in cases of low cardiac risk female patients. This is one such case report of a black female patient, who suffered an acute anterior wall myocardial infarction due to an idiopathic spontaneous coronary artery dissection of the left anterior descending artery. She was treated with a thrombolytic agent in the acute phase, uneventfully. An urgent coronary angiogram demonstrated an intimal tear with a dissection of the left anterior descending artery. She survived the acute event and her subsequent hospital course was uncomplicated. Hence she was treated medically for her ischemic event and left ventricular systolic dysfunction with a favorable outcome. This case is yet another report of a survivor treated with a thrombolytic agent for the acute myocardial infarction due to spontaneous coronary artery dissection.     

Heavy snoring as a cause of carotid artery atherosclerosis

STUDY OBJECTIVES: Previous studies have suggested that snoring and obstructive sleep apnea hypopnea syndrome may be important risk factors for the development of carotid atherosclerosis and stroke. However, it is not clear if snoring per se is independently related to the risk of developing carotid atherosclerotic plaque. DESIGN: Observational cohort study. SETTING: Volunteer sample examined in a sleep laboratory. PARTICIPANTS: One hundred ten volunteers (snorers and nonsnorers with only mild, nonhypoxic obstructive sleep apnea hypopnea syndrome) underwent polysomnography with quantification of snoring, bilateral carotid and femoral artery ultrasound with quantification of atherosclerosis, and cardiovascular risk factor assessment. Subjects were categorized into 3 snoring groups: mild (0%-25% night snoring), moderate (> 25%-50% night snoring), and heavy (> 50% night snoring). INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: The prevalence of carotid atherosclerosis was 20% with mild snoring, 32% with moderate snoring, and 64% with heavy snoring (P < 0.04, X2). Logistic regression analysis was used to determine the independent effect of snoring on the prevalence of carotid and femoral atherosclerosis. After adjustment for age, sex, smoking history, and hypertension, heavy snoring was significantly associated with carotid atherosclerosis (odds ratio 10.5; 95% confidence interval 2.1-51.8; P = 0.004) but not with femoral atherosclerosis. CONCLUSIONS: Heavy snoring significantly increases the risk of carotid atherosclerosis, and the increase is independent of other risk factors, including measures of nocturnal hypoxia and obstructive sleep apnea severity. Considering the high prevalence of snoring in the community, these findings have substantial public health implications for the management of carotid atherosclerosis and the prevention of stroke.