Malrotation of the gut with multiple anomalies in abdomen

DR. PATIL DEEPAK A.DR.HEREKAR NARSINH G.DR. JADHAV SHAILENDRA S.DR. KATTI ANUPAMA S.

Abstract: The complex arrangement of the viscera in the abdomen is readily appreciated from its development. Abnormal rotation or non-rotation of the gut leads to various anomalies of the gut and also the vessels supplying it. The aim of this paper is to present some anomalies which can be encountered during various surgeries. During cadaveric dissection we come across a case of malrotation of the gut with multiple anomalies. We found that the common hepatic artery which is normally a branch of celiac trunk is variably arising from the hepto-mesenteric trunk. The hepato-mesenteric trunk originated from ventral surface of aorta at L1 level and had length of 3cm. The trunk then divided into common hepatic artery and superior mesenteric artery. The common hepatic artery ascends laterally then it gives gastro-duodenal branch above superior part of duodenum which descends between duodenum and neck of pancreas. The common hepatic artery after giving gastroduodenal branch continues as hepatic artery proper. It ascends to the portahepatis and divides into right and left hepatic artery accompanying portal vein and hepatic duct.The caecum was present in rightlumbar quadrant of the abdomen under visceral surface of liver instead of right iliac fossa. The caecum was mobile, dilated with a blind pouch. Its dimensions were 7 x 9.5 (6 x 7.5cm-Normal).The duodenum was mobile instead of being fixed to posterior abdominal wall.

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