MyMedR

BACKGROUND: Axillary artery is known to show different variations mostly in its branching pattern. Similarly, the origin of profunda brachii is often encountered with abnormality. Therefore, when the vascular variations in the upper limb persist, mostly it is confined to its branching pattern followed by its variant origin. But, among all the reported variations of profunda brachii, its variant origin from the 3rd part of the axillary artery with common trunk for the branches of axillary artery is unique.

CASE DETAILS: We report here an anomalous origin of profunda brachii as continuation of an arterial trunk arising from 3rd part of the axillary artery. This common trunk at its commencement passed between 2 roots of median nerve and gave branches of 3rd part of axillary artery before it continued as profunda brachii artery. The further course and branching pattern of profunda brachii were normal.

CONCLUSION: Since the axillary artery is next choice of artery for arterial cannulation in cardiopulmonary bypass procedures, prior knowledge of existence of such variation in its branching pattern helps in avoiding possible diagnostic or interventional therapeutic errors.

Matched MeSH terms: Axillary Artery/abnormalities*; Brachial Artery/abnormalities*

Fulltext Congenital rudimentary medial meniscus--report of a case of development arrest of medial meniscus

Aranha A, Nor M

Singapore Med J, 1990 Apr;31(2):189-90.

PMID: 2371587

We present an unusual case, where the medial meniscus does not coincide with the embryological development of the formation of a discoid cartilage. A fairly, careful perusal of English literature since 1945 to date makes us feel that the following case merits recording. The meniscus had a normal anterior horn attached to the intercondylar area, in front of the anterior cruciate ligament. Medially, it was attached to the capsule and the condylar surface of the medial tibial plateau. The posterior horn was rounded, smooth, and floating free of any attachments. It was approximately 2 cms in length, semilunar in shape, and extended posteriorly up to the anterior margin of the medial collateral ligament. The rest of the medial tibial plateau had no other protective covering.

Matched MeSH terms: Cartilage, Articular/abnormalities*; Menisci, Tibial/abnormalities*

Obstructed Hemivagina Ipsilateral Renal Agenesis (OHVIRA) Syndrome-A Retrospective Cohort Analysis of the Sabah Population

Lim LM, Sivapatham L, Chong ASL, Wahab AVA

J Pediatr Adolesc Gynecol, 2023 Dec;36(6):541-544.

PMID: 37451429 DOI: 10.1016/j.jpag.2023.07.002

OBJECTIVES: The objectives of the study were to compare the demographic characteristics, presenting complaints, timeliness of diagnosis, and treatments given to all patients diagnosed with obstructive hemivagina ipsilateral renal agenesis (OHVIRA) between the adolescent group (age 10-19) and the adult group (age 20 and above) and to propose a feasible screening test consisting of routine bedside ultrasound to detect renal anomalies in addition to pelvic ultrasound during the assessment of females with gynecologic complications in resource-limited settings.

METHOD AND ANALYSIS: We conducted a retrospective cohort analysis of all patients with OHVIRA at our institution, Sabah Women and Children's Hospital, Malaysia, between the 2013 and 2022. Data were collected by reviewing patients' medical notes.

RESULTS: There were a total of 18 patients diagnosed with OHVIRA from 2013 to 2022, aged 10-41 years old. Nine patients (50%) presented during adolescence. Most (88.9%) came with symptoms such as abdominal pain, urinary symptoms, abnormal uterine bleeding, foul-smelling vaginal discharge, and primary infertility, whereas only 2 patients (11.1%) were asymptomatic and diagnosed incidentally. Acute abdomen was more common in the adolescent group (P = .015). No significant difference was found on the side of the renal anomaly.

CONCLUSION: Presenting symptoms vary and are often mimicked other gynecologic or surgical conditions, making the diagnosis difficult and delayed. Some patients were incidentally diagnosed while being managed for other problems, and it was not uncommon to have unnecessary surgery before the correct diagnosis was made. We suggest that all female patients with abdominal and pelvic complaints should be screened for renal anomaly during pelvic scan to improve diagnostic rates.

Matched MeSH terms: Kidney/abnormalities; Uterus/abnormalities

Diagnosis and treatment of branchial cleft anomalies in UKMMC: a 10-year retrospective study

Zaifullah S, Yunus MR, See GB

Eur Arch Otorhinolaryngol, 2013 Mar;270(4):1501-6.

PMID: 23053382 DOI: 10.1007/s00405-012-2200-7

Branchial cleft anomalies result from abnormal persistence of branchial apparatus, which is located at the lateral part of the neck. These occur due to failure of obliteration of the branchial apparatus during embryonic development. Differential diagnoses of lateral neck mass are salivary gland or neurogenic neoplasms, paragangliomas, adenopathies, cystic hygroma or cystic metastasis from squamous cell carcinoma or thyroid papillary carcinoma. Clinically, a branchial cyst is smooth, round, fluctuant and non-tender, and usually occurs over the upper part of the neck, anterior to the sternocleidomastoid muscle. Sometimes, it may present as infected cyst (or abscess), a sinus or fistula. Surgical excision is the definitive treatment for branchial anomalies. The objective of the work was to study the demographic data, clinical presentation, definite diagnostic workup and treatment of patients diagnosed with branchial anomalies. This is a retrospective study of 26 patients who were diagnosed with branchial anomalies (branchial cyst and fistula), of which only 12 patients had data available between July 1999 and June 2009 at the Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre. Twelve cases of branchial anomalies were seen, in which 10 patients had second branchial cyst anomalies, 1 had third branchial fistula and 1 had bilateral branchial lesion. There were seven females and five males. The age of the patients varied over a wide range (4-44 years), but the majority of the patients were in their second and third decade of life. All branchial anomalies occurred at the classical site; eight patients had left-sided neck lesion. Correct clinical diagnosis was made only in five patients (41.6 %). All patients underwent surgical excision with no reported recurrence. Branchial anomalies are frequently forgotten in the differential diagnosis of lateral neck swelling. Diagnosis is usually delayed, leading to improper treatment. The diagnosis of patients who present with lateral neck cystic swelling with or without episodes of recurrent neck abscess should be considered with a high suspicion for branchial anomalies. FNA cytology is a good investigative tool in reaching toward a diagnosis of branchial lesion, with the concurrent assistance of radiological modalities. Surgical excision is the gold standard treatment of lesions of branchial anomalies.

Matched MeSH terms: Branchial Region/abnormalities; Craniofacial Abnormalities/diagnosis*; Craniofacial Abnormalities/pathology; Craniofacial Abnormalities/surgery*

Enamel defects in a fluoridated south-east Asian community

Chellappah NK, Vignehsa H, Lo GL

Aust Dent J, 1990 Dec;35(6):530-5.

PMID: 2090085

The prevalence and distribution patterns of enamel defects in maxillary incisors was assessed in 194 Singaporean children aged 11-15 years and belonging to three different ethnic groups. All were born and continuously resident in Singapore, which has a tropical climate. The water supply was fluoridated in 1957 at a level of 0.7 ppm. The mouth prevalence of defects was 71.5 per cent and the tooth prevalence was 55.9 per cent; 82 per cent of all affected teeth demonstrated white lesions of various forms. Although there was no sex difference in the prevalence and distribution pattern of defects, some racial differences were observed. The results were compared with data from other studies where the same classification of defects was used.

Matched MeSH terms: Congenital Abnormalities/ethnology; Congenital Abnormalities/epidemiology; Dental Enamel/abnormalities*; Incisor/abnormalities

Fulltext Pneumonectomy for congenital isolated unilateral pulmonary artery agenesis

Britton J, Sachithanandan A, Srinivasan L, Ghosh S

Med J Malaysia, 2011 Oct;66(4):363-4.

PMID: 22299560 MyJurnal

Unilateral pulmonary artery agenesis (UPAA) is a rare congenital anomaly usually diagnosed in infancy due to associated cardiovascular malformations. We report a rare case of isolated right UPAA that presented atypically in adulthood with massive haemoptysis requiring a pneumonectomy. This case highlights the importance of maintaining a high clinical suspicion, the role of CT angiography and a multi disciplinary approach. Optimal management is often surgical however bronchial artery embolization (BAE) remains a useful adjunct.

Matched MeSH terms: Pulmonary Artery/abnormalities*

Variant course of posterior circumflex humeral artery associated with the abnormal origin of radial collateral artery: could it mimic the quadrangular space syndrome?

Mohandas Rao KG, Somayaji SN, Ashwini LS, Ravindra S, Abhinitha P, Rao A, et al.

Acta Med Iran, 2012;50(8):572-6.

PMID: 23109033

Variations in the origin of axillary artery branches are common. But, distinctly abnormal course of its posterior circumflex humeral branch is rare. We are reporting a case of posterior circumflex humeral artery (PCHA) originating from the axillary artery, passing through lower triangular space to reach the scapular region where it accompanied the axillary nerve and posterior circumflex humeral vein to pass around surgical neck of humerus, deep to the fibers of deltoid. Other variations observed in this specimen were the radial collateral artery arising from the PCHA, middle collateral artery arising directly from the brachial artery and absence of profunda brachii artery. PCHA forming a hair pin loop, traversing through lower triangular space instead of quadrangular space taking a long course is being reported for the first time. Further, the clinical and surgical importance of this case especially in relation with quadrangular space syndrome and relevant literature is discussed.

Matched MeSH terms: Radial Artery/abnormalities*

Atlanto-occipital fusion: an osteological study with clinical implications

Kassim NM, Latiff AA, Das S, Ghafar NA, Suhaimi FH, Othman F, et al.

Bratisl Lek Listy, 2010;111(10):562-5.

PMID: 21125803

Atlanto-occipital fusion may be symptomatic or asymptomatic in nature. The anomaly may be incidentally detected at autopsies or during routine cadaveric dissections. The fusion of the atlas with occipital bone may result in the compression of vertebral artery and first cervical nerve.

Matched MeSH terms: Atlanto-Occipital Joint/abnormalities*

A case of disproportionate macrodactyly or a mild form of Proteus syndrome? An interesting case

Abdullah S, Haflah NH, Sapuan J, Das S

Acta Medica (Hradec Kralove), 2010;53(4):243-6.

PMID: 21400985

We present a 20-year-old Malay male whom we believe has Proteus syndrome, a rare congenital disorder of asymmetrical overgrowth of body tissues. There are fewer than 100 confirmed cases reported worldwide thus the clinical presentation and histopathological findings are of significance. Our patient presented with an overgrown right small finger and subcutaneous purplish pigmentation over his left upper arm and chest since birth. His small finger gradually increased in size. He had no abnormalities in sensation or power. Radiographs revealed a delta shaped middle phalanx of the small finger. His activities of daily living were uninterrupted but he requested debulking surgery for cosmetic reasons. Histopathological examination reported hypertrophic fatty tissue composed of well formed lobules of mature adipocytes interspersed with fibrous elements.

Matched MeSH terms: Fingers/abnormalities*

Abnormal course of left testicular artery in relation to an abnormal left renal vein: a case report

Satheesha NB

Kathmandu Univ Med J (KUMJ), 2007 Jan-Mar;5(1):108-9.

PMID: 18603997

The testis is an important organ upon which the survival of the human species depends. Any compression of testicular artery may lead to loss of gametogenesis and hormone production. We found a left testicular artery entrapped between two divisions of a left renal vein in an approximately 50 year old cadaver. The left renal vein was formed by union of two veins coming from the kidney, left suprarenal vein, left testicular vein and an abnormally enlarged lumbar vein. This case may be of particular importance to surgeons who transplant kidneys, radiologists and orthopaedic surgeons dealing with the spine repairs.

Matched MeSH terms: Renal Veins/abnormalities*

Anomalous higher branching pattern of the femoral nerve: a case report with clinical implications

Das S, Vasudeva N

Acta Medica (Hradec Kralove), 2007;50(4):245-6.

PMID: 18290549

The femoral nerve usually divides into anterior and posterior branches below the inguinal ligament. In the present case, we report the anomalous higher branching pattern of the femoral nerve on both sides of a 52 year male cadaver. The femoral nerve divided into the anterior and posterior branches above the inguinal ligament. Such a higher division of femoral nerve is a rare finding and it may be important for surgeons, orthopaedicians and anaesthetists in day to day clinical practice.

Matched MeSH terms: Femoral Nerve/abnormalities*

The additional tendons of the extensor digitorum muscle of the hand: an anatomical study with a clinical significance

Das S, Sulaiman IM, Hussan F, Latiff AA, Suhaimi FH, Othman F

Bratisl Lek Listy, 2008;109(12):584-6.

PMID: 19348385

The extensor digitorum (ED) muscle of the hand originates from the lateral condyle of the humerus and splits into four tendons; each for one phalanx except the thumb. Literature reports have described multiple tendons (usually two) to each digit but in the presented study we observed four tendons to the ring finger, what is rare. During a routine dissection of the cadavers, we observed an anomalous arrangement of the ED tendon on the left hand of a 42-year-old male. The anomalous tendons to the ring finger were studied in detail, the surrounding structures were carefully delineated and the specimen was photographed. The ED muscle originated as usual from the lateral condyle of the humerus, continued downwards, passing inferiorly to the extensor retinaculum to split into individual tendons for each of the digits. There was a single tendon to the index, middle and ring finger as usual but the ring finger displayed four tendons. All the tendons attached to the phalanges were as described in anatomy textbooks. The arrangement of the anomalous tendons of ED to each of the digits is not uncommon, but existence of four tendons to the ring finger is extremely rare. The increased number of tendons to the ring finger may increase the extension component of the ring finger. Anatomical knowledge of the tendons of the extensor muscles of the hand may be also beneficial for hand surgeons performing graft operations (Fig. 2, Ref. 11). Full Text (Free, PDF) www.bmj.sk.

Matched MeSH terms: Tendons/abnormalities

Fulltext Bilateral lacrimal sac mucocele with punctal and canalicular atresia

Ong CA, Prepageran N, Sharad G, Luna D

Med J Malaysia, 2005 Dec;60(5):660-2.

PMID: 16515124

Congenital absence of lacrimal puncta may be an isolated finding or associated with other developmental abnormality. Nasolacrirnal ducts can be absent thus predisposing to the formation of a congenital lacrimal mucocele. Punctal and canalicular agenesis is very rare. Four percent of new patients attending the lacrimal clinic at Moorfields Eye Hospital, London, UK. from 1981 to 1990 inclusive were diagnosed to have this condition. We describe a case of bilateral congenital absence of lacrimal puncta with lacrimal mucocele. Combined surgery was carried out by Ophthalmologist and Otolaryngologist with successful results.

Matched MeSH terms: Lacrimal Apparatus/abnormalities*

Surgically important variations of the jugular veins

Nayak BS

Clin Anat, 2006 Sep;19(6):544-6.

PMID: 16372344

Knowledge of variations of veins of head and neck in relation to external jugular, anterior jugular, internal jugular, and facial veins is important to surgeons doing head and neck surgery as well as to radiologists doing catheterization and to clinicians in general. In the current case, multiple variations in the veins of the left side of neck are reported. The anterior division of retromandibular vein was absent. The facial vein continued as anterior jugular vein. The internal jugular vein was duplicated above the level of hyoid bone. There was a large communicating vein between the anterior jugular vein and anterior division of internal jugular vein. Lingual vein drained into the communicating vein. Jugular venous arch was abnormally large, doubled, and highly placed. The veins of the right side were normal.

Matched MeSH terms: Jugular Veins/abnormalities*

Fulltext Congenital nasal encephalocele--a review of surgical techniques

Zamzuri I, Abdullah JM, Samsudin AR

Med J Malaysia, 2004 Oct;59(4):552-4.

PMID: 15779595

We report a case of a 6 month old baby boy who had congenital nasal encephalocele, repaired via the traditional staging procedure. The surgical techniques and procedures are described and discussed.

Matched MeSH terms: Cerebellum/abnormalities*

Unusual branching pattern of brachial artery - Embryological basis and clinicoanatomical insight

Hansdak R, Arora J, Sharma M, Mehta V, Suri RK, Das S

Clin Ter, 2015;166(2):65-7.

PMID: 25945432 DOI: 10.7417/CT.2015.1817

Variations in the arterial pattern of upper limb are of colossal importance to the surgeons as they are liable to iatrogenic injuries. During routine dissection for undergraduate medical students, an anomaly of brachial artery was discovered. The brachial artery terminated at higher level into ulnar and radial artery. The common interosseus artery took origin arising from radial artery. The ulnar artery did not give any branches in the forearm. Both radial and ulnar artery displayed a superficial course in the forearm. The anatomical knowledge of these variations may be of great help for the clinicians in planning and conducting flap harvesting during reconstructive surgeries and in arteriography.

Matched MeSH terms: Brachial Artery/abnormalities*

Fulltext The importance of intraoperative evaluation in the management of anorectal atresia

Ramesh JC, Lu, Balasingh D, Qureshi A

Med J Malaysia, 2002 Sep;57(3):361-3.

PMID: 12516531

We report a neonate with anorectal atresia in whom preoperative evaluation prior to definitive operation revealed a short gap atresia. However, bidigital evaluation at operation revealed a septal atresia that was easily perforated from below through the anus. Unnecessary division of the anorectal sphincter complex was thus avoided.

Matched MeSH terms: Rectum/abnormalities*

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