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The celiac trunk is the first major branch of the abdominal aorta. It originates from the ventral aspect of the aorta at the level of T12–L1 vertebrae and was originally described as an artery that branches into the common hepatic artery, left gastric artery, and splenic artery. Absence of the celiac trunk and origin of the three arteries separately from the aorta is a rare entity that is reported in 0.38% to 2.6% of cases. It is even more uncommon that this variation can be accompanied by other vascular variations of the upper abdomen as accessory arteries to the liver, stomach, and pancreas. These cases arise during embryogenesis due to decreased arterial degeneration combined with decreased arterial fusion, which results in the anatomical variations present in the current case. Complex arterial variations are both a risk for iatrogenic injury during surgical procedures and beneficial during endovascular supply as they may provide additional access for embolization and chemotherapy.

Anomalies and variants of development of the pancreas are relatively frequent. Bifid pancreatic tail is a rare anatomic variation with only a few cases reported in the literature. The present case series were encountered during dissection of 50 anatomical specimens of the pancreas, spleen, and duodenum. We observed four unusual cases (8%) of bifid pancreatic tail. One case was of a vertically oriented bifid pancreas tail (2%), in another case, the tails here horizontally oriented (2%) and in two cases the bifid tails were horizontally oriented but unequal (4%). The bifid tails had an arterial supply that penetrated the glands between the tails and two out of four were also supplied by the superior horizontal pancreatic artery of Popova. The ductal system usually bifurcated at the level of the tails, but a case of trifurcation was also encountered. The current cases should be taken into account in hepato-pancreato-biliary surgery to avoid misdiagnosis and to comprehensively assess the patient preoperatively.

Background: Precise knowledge of the topographic features of the splenic artery and its branches in the hilum region is of practical interest due to the various interventions on the vessels of the spleen. Materials and methods: The anatomy of the spleen was studied by means of macroscopic dissection on 330 organ complexes, which were carefully documented and analyzed statistically. Results: The analysis of the splenic artery trajectory led to identification of four types: straight (43.03%), sinusoidal (27.58%), serpentine (20.91%) and alternating (8.48%). To assess the relation between the trajectory of the splenic artery and its branches we performed a chi square test. Sinuous or serpentine trajectory was associated with the presence of long splenic artery branches (dorsal pancreatic artery or the great pancreatic artery), X2 (2, N = 330) = 12.85, p = 0.001. The artery was located suprapancreatic in 70.30% of cases, anteropancreatic in 4.55%, the vessel had an intrapancreatic course in 14.85% and in 10.00% of cases the artery was located retropancreatic. The presence of inferior polar arteries was associated with a longer pancreas (Spearman’s correlation; r = 0.37; p = 0.037). In a multiple regression analysis, inferior polar arteries predicted the length of the pancreas although only a small number of cases could be explained by this model (R2 = 0.127, Adjusted R2 = 0.098; Betta = 0.357; t(330) = 2.091; p = 0.045). There were 30 (9.09%) cases of accessory spleens. Conclusions: The arterial supply of the spleen is highly variable in its trajectory, terminal branches, and relation to other organs. The splenic artery tends to be sinuous or serpentine in zones when a large artery branches off (e.g., the dorsal pancreatic or greater pancreatic artery). Multiple short branches tend to stabilize the trajectory of the splenic artery. Inferior polar arteries and accessory spleens contribute to the length of the pancreas, most likely due to increased vascular supply to the tail of the gland.

Asthma is the most common chronic respiratory disease worldwide and its prevalence is increasing. Acute asthma complications are often the reason for admission to emergency healthcare service. In our article we present a case of a rare asthma complication – spontaneous pneumomediastinum with a short review of its incidence, etiology, diagnosis and management. Spontaneus pneumothorax is important to differentiate with secondary pneumomediastinum as well as other conditions as cardiac diseases (acute coronary syndrome, pericarditis, cardiac tamponade, pneumopericardium), lung diseases (pneumothorax, pulmonary embolism, tracheobronchial tree rupture), musculoskeletal disorders, and diseases of the esophagus (rupture and perforation o the esophagus). A chest X-ray is often reliable for diagnosis of spontaneous pneumomediastinum and when inconclusive, can be followed by CT. The management is usually conservative with oxygen and analgesia. Surgery is required only in cases of tracheobronchial compression.

Abstract In this article we present a rare variant in which the large intestine was vascularized by the inferior mesenteric artery. It was encountered during macro and microscopic dissection of the cadaver of a 63-year-old woman at a university department of human anatomy. In this case, the ascending, transverse, descending, and sigmoid colon and rectum were vascularized by the inferior mesenteric artery, whereas the small intestine, cecum and appendix were supplied by the superior mesenteric artery.

The thymus is a primary lymphoid organ of the immune system, that plays a vital role in the development and maturation of the immune system during childhood. During the dissection we encountered an unusual thymus, located in the anterior mediastinum, which had a narrow, L-shaped accessory lobe and was located on the right side of the pericardium, covering the right ventricle from its base to the place of adhesion to the diaphragm. Its length was 6.7 cm, the width of the narrowest segment was 1.1 cm, and at the widest part was 2 cm, with the average segment thickness of 0.4 cm. The presence of accessory thymic lobes that extend till the level of the diaphragm creates difficulties during surgery especially in case of thoracoscopic procedures as the tissue lies on the pericardium in a narrow space thus making the dissection more difficult.

The anatomy of the first vertebra, namely atlas, has significant clinical implications. One of the clinically significant anatomical variants is the presence of an arcuate foramen. Arcuate foramen of atlas is an ossification of the oblique atlanto-occipital ligament superior to the vertebral artery groove of the atlas. The vertebral artery, which passes under these bony projections, can be compressed along with the suboccipital nerve causing a variety of symptoms. We present a series of anatomical case reports from a collection of 50 atlases with their analysis and brief review of their clinical significance. This anomaly is an underestimated structure, which is important to take into account in case of patients with a headache, vertigo, shoulder and arm pain, since in case of complete arcuate foramen, the number of symptomatic patients can be up to 78%.

In comparison with other organs, variants of blood supply to the kidneys were always at special attention. In many respects, the relevance of the topic can be explained by the presence of a large number of surgical and non-surgical procedures performed on this organ, the number of which continues to grow. We therefore analyzed renal artery variations by the method of macroscopic anatomical dissection on 56 kidneys and retrospectively analyzed the data of 93 aortography performed using the Seldinger technique. In our study, one renal artery was encountered in 45 cases (80.34%) based on dissection method and in 156 cases (83.87%) based on angiography. Two renal arteries were found in 11 cases (19.64%) according to the dissection method and in 30 cases (16.13%) according to the data of the aortography. Bifurcation of the renal artery occurred in 5 cases (8.93%) and trifurcation – 2 cases (3.57%). Based on the angiography data bifurcation was detected in 16 cases (8.60%) and in trifurcation in 3 case (1.61%). Extrarenal division occurred in 10 cases (17.86%). Based on dissection method the superior polar arteries were recorded in 12 cases (21.43%). On angiographies, the superior polar arteries were encountered in 10 cases (5.38%) and inferior polar arteries – in 2 cases (1.08%). The data provided in the article can be used by specialists in urology, nephrology, vascular surgery, as well as in other therapeutic and surgical specialties.

The advances of our knowledge of the anatomical structure of the liver led to the development of complicated interventional procedures, which have became more widely used in the last decades. Accessory liver fissures are a frequent anomaly that can lead to complications during diagnostic and surgical procedures. In our article, we present a description of two cases of accessory liver fissures and a review of their clinical significance.

Introduction: Anatomical structures serve as landmarks for dental procedures. Therefore, in our present study, we determined the most common anatomical variations of mandibles. Material and Methods: The study included 50 dry mandibles from the department of human anatomy obtained from patients of Moldavian origin. The obtained data was analysed using descriptive statistics and Pearsons correlation. A p level of less than 0.05 was considered to be statistically significant. Results: The mandibular foramen was situated in the inferior 1/3 of mandibular ramus in 30 cases (60%). In 20 cases (40%) the mandibular foramen was situated in the middle of the ramus. Both premolar foramen and accessory mandibular foramen was encountered in two cases respectively (4%). Mylohyoid bridging was also encountered in two cases (4%). The condylar morphology differed according to its surface and was classified into four types: type A - superior surface flattened, type B - superior surface convex, type C - superior surface angled and type D - superior surface rounded. The morphology of the left condylar process according to the types: A – 20 cases (40%), B – 16 cases (32%), C – 2 (4%), D – 12 (24%). The morphology of the right condylar process according to the types: A – 16 cases (32%), B – 20 (40%), C – 6 (12%), D – 8 (16%). There were four common forms of the lingula: triangular lingula (type 1), truncated lingula (type 2), lingula seen as a less prominent nodule (type 3), lingula assimilated in the mandibular ramus (type 4). The lingual type from the right side: type 1 – 8 (16%), type 2 – 18 (36%), type 3 – 18 (36%) and type 4 – 6 (12%). The lingual type from the left side: type 1 – 10 (20%), type 2 – 18 (36%), type 3 – 18 (36%) and type 4 – 6 (12%). Conclusions: The anatomy of the mandible has several clinically significant anatomical variations, which should be taken into consideration in daily dentist practice. The data provided in the article discusses some of the variations of the development and morphological parameters of mandibles from the Moldavian population.

Anomalies and variants of development of the pancreas are relatively frequent. Bifid pancreas tail is a rare developmental variant an there are only a few case descriptions in the literature. There were also no reports of significant vascular variations associated with bifid pancreas tail. We present a case of a bifid pancreas tail associated with superior horizontal pancreatic artery of Popova encountered during an anatomical dissection of a 64 years old male cadaver with a detailed analysis of the vascularization of the gland and its ductal system morphology.

Introduction: In comparison with other organs, variants of blood supply to the kidneys were always at special attention. In many respects, the relevance of the topic can be explained by the presence of a large number of surgical and non-surgical procedures performed on this organ, the number of which continues to grow. Material and methods: The study was performed on 28 organ complexes (56 kidneys) obtained from patients of Moldavian origin, fixed in a 10% formalin solution and then carefully dissected. Results: In our study, we found one renal vein in 51 cases (90.1%). Accessory right renal vein was detected in 5 cases (9.9%). Late venous confluence was in seven cases (12.46%), and more often, this variant of venous outflow was seen on the right - 5 cases. We also had a rare case where the adrenal vein drained directly into the upper pole of the kidney (1.78%). In one case (1.78%) we found a left renal vein, which had a retroaortic location. We also found one case (1.78%) of an additional vein on the right and an additional artery on the left. In 20 cases (35.6%) the artery was located in front of the vein in the kidney sinus. Conclusions: The incidence of renal vein variations is relatively lower in Moldavian population compared to other studies. Data, provided in the article, can be used by specialists in urology, nephrology, vascular surgery, as well as in other surgical and therapeutic specialties.

We describe a case report of multiple arterial variations of internal organs of upper abdominal cavity in a cadaver of 63-year-old female. There were several developmental variations of the vascular supply of the stomach, pancreas, spleen, and liver. There were several accessory arteries: left gastric, left hepatic, and posterior gastric artery as well as several arteries that had abnormal origin. The variations were discovered during macroscopical dissection at the department of human anatomy. It should be noted that multiple developmental variation can be common in clinical practice and clinicians should be aware of them during diagnostic and interventional procedures.

In the past decade there was an increase in the frequency of operations on the pancreas. This is largely due to the decrease in postoperative mortality and complications of these procedures. Knowledge of variant anatomy of this organ can help to avoid blood loss and irreversible necrotic changes of the abdominal cavity as a result of surgery. During macro and microscopical anatomical dissection of a 72 years old male organ complex, we discovered a rare variant of arterial blood supply to the tail and body of the pancreas.

In the last years, there is an increase in the number of complex surgical procedures on the spleen. This process couldn’t have gone unnoticed and eventually caused a growth of interest toward this abdominal cavity organ. Acessory spleen represents one of the crucial anatomical variations of the spleen and has major clinical significance. During the anatomical dissection of 35 organ complexes, we encountered 3 cases of accessory spleen, which represents 8.6% of the total number of cases. In this article, we present the three accessory spleen cases with a review of their clinical significance.

The splenic artery is characterized by large individual variability on both extra-and intraorganic levels. The authors describe the case of an accessory splenic artery, which was found in the study of corrosion cast preparation. An accessory artery diameter of 0.1 mm was diverted at a sharp angle from the upper branch of the splenic artery and at the level of the hilum branched into two vessels of I and II order from a sharp angle. In the parenchyma it accompanied the segmental arteries and had a shared blood supply with them.

Anomalies and developmental variations of organs and anatomical structures are always at special attention since they often have clinical significance and at the same time may present a clinical challenge. The double suprascapular foramen is considered to be a rare variation of development and there were only few cases described in the literature. It also was proposed as a possible cause of suprascapular nerve entrapment syndrome. We present a case of double suprascapular foramen in a male cadaver with a review of its importance and probable cause.

Abstract We describe a case of unusual development of the celiac trunk observed in the cadaver of 1-year old male child. The celiac trunk branched into five vessels: the splenic, common hepatic and left gastric arteries, the left inferior diaphragmatic artery, and a short trunk that branched into the right inferior diaphragmatic artery and right accessory hepatic artery. Additionally, the manner of branching of the vessel was unusual: it was possible to distinguish two branching points that corresponded to its s-shaped trajectory. There were also other variations of vascular supply, such as the presence of a left accessory hepatic artery, an additional superior pancreatoduodenal artery, and others. It should be noted that multiple developmental variations can be common in clinical practice and clinicians should be aware of them during diagnostic and interventional procedures.