Surg Radiol Anat DOI 10.1007/s00276-013-1252-8
Anatomic Variations
Internal supravesical hernia accompanied with anomalous fold formations: a cadaveric case report Nail Can Öztürk · Zeliha Kurtog˘lu
Received: 19 July 2013 / Accepted: 27 December 2013 © Springer-Verlag France 2014
Abstract During the abdominal dissection of a 67-yearold male cadaver, an unusual peritoneal fold was encountered on the inner surface of the anterior abdominal wall. The peritoneal fold had two parts: the anterior part was located at the midsagittal plane including dispersed urachus remnants, the other part was located at the coronal plane with a triangular shape at the posterior edge of the sagittal part. Remnants of the umbilical arteries were ascending in the lateral margins of the coronal part. Accordingly, two peritoneal sacs were formed on both sides of this abnormal fold. Part of the small bowel herniated into the left peritoneal sac situated on the left side of the bladder. Although the aperture of the hernia sac was at the lateral side of the remnant of the umbilical artery which is concordant with the normal position of the medial inguinal fossa, the bottom of the sac was found to be located at the supravesical region. Therefore, this case was interpreted as an internal supravesical hernia with an unusual course. Although these rarely seen internal supravesical hernias in the literature were reported to be observed either preoperatively or postoperatively, to our knowledge our case is the first to be revealed in a cadaver which in detail enabled us to examine the features of this unique peritoneal variation and accompanying anatomic structures that caused hernia formation. Keywords Median umbilical fold · Medial umbilical fold · Variation · Internal supravesical hernia
N. C. Öztürk (*) · Z. Kurtog˘lu Department of Anatomy, Faculty of Medicine, Mersin University, Ciftlikkoy Campus, 33343 Mersin, Turkey e-mail: [email protected]
Introduction The supravesical fossa is a triangular area bounded superiorly by the median and medial umbilical ligaments and inferiorly by the peritoneal reflection passing from the anterior abdominal wall to the dome of the bladder. It is the site of supravesical hernias [3, 4, 10]. A supravesical hernia (SVH) is a rarely seen entity, and classified as internal and external in the literature [6]. A hernia starting in this fossa usually protrudes through the abdominal wall as a direct inguinal hernia (external supravesical hernia). Less commonly, it remains within the abdomen, passing into spaces around the bladder (internal supravesical hernia). This type of hernia can result in intestinal obstruction and cause difficulties in the diagnosis [3]. Hernias represent the second most common cause of small bowel obstruction and internal hernias have an overall incidence of
Anatomic Variations
Internal supravesical hernia accompanied with anomalous fold formations: a cadaveric case report Nail Can Öztürk · Zeliha Kurtog˘lu
Received: 19 July 2013 / Accepted: 27 December 2013 © Springer-Verlag France 2014
Abstract During the abdominal dissection of a 67-yearold male cadaver, an unusual peritoneal fold was encountered on the inner surface of the anterior abdominal wall. The peritoneal fold had two parts: the anterior part was located at the midsagittal plane including dispersed urachus remnants, the other part was located at the coronal plane with a triangular shape at the posterior edge of the sagittal part. Remnants of the umbilical arteries were ascending in the lateral margins of the coronal part. Accordingly, two peritoneal sacs were formed on both sides of this abnormal fold. Part of the small bowel herniated into the left peritoneal sac situated on the left side of the bladder. Although the aperture of the hernia sac was at the lateral side of the remnant of the umbilical artery which is concordant with the normal position of the medial inguinal fossa, the bottom of the sac was found to be located at the supravesical region. Therefore, this case was interpreted as an internal supravesical hernia with an unusual course. Although these rarely seen internal supravesical hernias in the literature were reported to be observed either preoperatively or postoperatively, to our knowledge our case is the first to be revealed in a cadaver which in detail enabled us to examine the features of this unique peritoneal variation and accompanying anatomic structures that caused hernia formation. Keywords Median umbilical fold · Medial umbilical fold · Variation · Internal supravesical hernia
N. C. Öztürk (*) · Z. Kurtog˘lu Department of Anatomy, Faculty of Medicine, Mersin University, Ciftlikkoy Campus, 33343 Mersin, Turkey e-mail: [email protected]
Introduction The supravesical fossa is a triangular area bounded superiorly by the median and medial umbilical ligaments and inferiorly by the peritoneal reflection passing from the anterior abdominal wall to the dome of the bladder. It is the site of supravesical hernias [3, 4, 10]. A supravesical hernia (SVH) is a rarely seen entity, and classified as internal and external in the literature [6]. A hernia starting in this fossa usually protrudes through the abdominal wall as a direct inguinal hernia (external supravesical hernia). Less commonly, it remains within the abdomen, passing into spaces around the bladder (internal supravesical hernia). This type of hernia can result in intestinal obstruction and cause difficulties in the diagnosis [3]. Hernias represent the second most common cause of small bowel obstruction and internal hernias have an overall incidence of
