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Konarska-Włosińska M, Ostrowski P, Del Carmen Yika A, Dziedzic M, Bonczar M, Wojciechowski W, Walocha J, Koziej M. Exploring the Topography of the Obturator Artery and Corona Mortis: a Detailed Analysis with Surgical Implications. Int Urogynecol J 2024:10.1007/s00192-024-05774-8. [PMID: 38635039 DOI: 10.1007/s00192-024-05774-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 03/06/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION AND HYPOTHESIS The obturator artery (ObA) is described as a branch of the anterior division of the internal iliac artery. It arises close to the origin of the umbilical artery, where it is crossed by the ureter. The main goal of the present study was to create an anatomical map of the ObA demonstrating the most frequent locations of the vessel's origin and course. METHODS In May 2022, an evaluation of the findings from 75 consecutive patients who underwent computed tomography angiography studies of the abdomen and pelvis was performed. RESULTS The presented results are based on a total of 138 arteries. Mostly, ObA originated from the anterior trunk of the internal iliac artery (79 out of 138; 57.2%). The median ObA diameter at its origin was found to be 3.34 mm (lower quartile [LQ] = 3.00; upper quartile [UQ] = 3.87). The median cross-sectional area of the ObA at its origin was found to be 6.31 mm2 (LQ = 5.43; UQ = 7.32). CONCLUSIONS Our study developed a unique arterial anatomical map of the ObA, showcasing its origin and course. Moreover, we have provided more data for straightforward intraoperative identification of the corona mortis through simple anatomical landmarks, including the pubic symphysis. Interestingly, a statistically significant difference (p < 0.05) between the morphometric properties of the aberrant ObAs and the "normal" ObAs originating from the internal iliac artery was found. It is hoped that our study may aid in reducing the risk of serious hemorrhagic complications during various surgical procedures in the pelvic region.
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Affiliation(s)
- Monika Konarska-Włosińska
- Department of Anatomy, Jagiellonian University Medical College Mikołaja, Kopernika 12, 33-332, Kraków, Poland
| | - Patryk Ostrowski
- Department of Anatomy, Jagiellonian University Medical College Mikołaja, Kopernika 12, 33-332, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Alicia Del Carmen Yika
- Department of Anatomy, Jagiellonian University Medical College Mikołaja, Kopernika 12, 33-332, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Martyna Dziedzic
- Department of Anatomy, Jagiellonian University Medical College Mikołaja, Kopernika 12, 33-332, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Michał Bonczar
- Department of Anatomy, Jagiellonian University Medical College Mikołaja, Kopernika 12, 33-332, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Wadim Wojciechowski
- Department of Radiology, Jagiellonian University Medical College, Kraków, Poland
| | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University Medical College Mikołaja, Kopernika 12, 33-332, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Mateusz Koziej
- Department of Anatomy, Jagiellonian University Medical College Mikołaja, Kopernika 12, 33-332, Kraków, Poland.
- Youthoria, Youth Research Organization, Kraków, Poland.
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Plutecki D, Ostrowski P, Bonczar M, Michalik W, Konarska-Włosińska M, Goncerz G, Juszczak A, Ghosh SK, Balawender K, Walocha J, Koziej M. Exploring the clinical characteristics and prevalence of the annular pancreas: a meta-analysis. HPB (Oxford) 2024; 26:486-502. [PMID: 38310080 DOI: 10.1016/j.hpb.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 12/17/2023] [Accepted: 01/15/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND The annular pancreas (AP) is a rare gastrointestinal congenital malformation, in which malrotation of the pancreatic ventral bud in the seventh week of embryonic development manifests in a partial or complete ring of tissue around the second part of the duodenum. METHODS The main online medical databases such as PubMed, ScienceDirect, Wiley online library, Web of Science, and EBSCO discovery service were used to gather all relevant studies on the AP. RESULTS A total of 12,729,118 patients were analyzed in relation to the prevalence of AP. The pooled prevalence of AP was 0.0045% (95% CI: 0.0021%-0.0077%). The most frequent comorbidity in adults and children was duodenal obstruction, with a pooled prevalence of 24.04% and 52.58%, respectively (95% CI: 6.86%-46.48% and 35.56%-69.31%, respectively). The most frequent operation in adult patients with AP was duodenojejunostomy, with pooled prevalence established at 3.62% (95% CI: 0.00%-10.74%). CONCLUSION The diagnostic complexity of AP is accentuated by its nonspecific clinical symptoms, making accurate identification reliant on imaging studies. Therefore, having a thorough knowledge of the clinical characteristics of the AP and its associated anomalies becomes paramount when faced with this rare congenital condition.
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Affiliation(s)
- Dawid Plutecki
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland; Youthoria, Youth Research Organization, Kraków, Poland
| | - Patryk Ostrowski
- Youthoria, Youth Research Organization, Kraków, Poland; Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Michał Bonczar
- Youthoria, Youth Research Organization, Kraków, Poland; Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Weronika Michalik
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | | | - Grzegorz Goncerz
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Aleksiej Juszczak
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland; Department of General Surgery, 5th Military Hospital, Kraków, Poland
| | - Sanjib K Ghosh
- Department of Anatomy, All India Institute of Medical Sciences, 3rd Floor, Academic Building, Phulwarisharif, Patna, Bihar 801507, India
| | - Krzysztof Balawender
- Department of Normal and Clinical Anatomy, Institute of Medical Sciences, Medical College, Rzeszow University, 35-315 Rzeszów, Poland
| | - Jerzy Walocha
- Youthoria, Youth Research Organization, Kraków, Poland; Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Mateusz Koziej
- Youthoria, Youth Research Organization, Kraków, Poland; Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland.
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