Pattern of Origin of Thoracic Splanchnic Nerves and their Clinical Implications for Sympathectomy and Splanchnicectomy-A Detailed Cadaveric Study
Journal Title: International Journal of Anatomy Radiology and Surgery - Year 2018, Vol 7, Issue 2
Abstract
Introduction: The sympathetic nervous system, which is the larger autonomic division, includes the two ganglionated trunks and their branches, plexuses and subsidiary ganglia. The thoracic part of the sympathetic system has been a fascinating field in surgery for long time. Although, the thoracic part of the sympathetic system has thus been an area of importance for physicians and surgeons, the knowledge of this region also present lacunae. The important reasons for unsuccessful sympathectomy include sympathetic regeneration, alternate sympathetic pathways and variations in their presentation. Aim: To investigate the origin and pattern of formation of the splanchnic nerves in order to establish a predictable pattern of splanchnic neural anatomy and to outline the surgical anatomy appropriate to effect adequate denervation of upper abdominal viscera. Materials and Methods: The present study is done in 10 cadavers. The thoracic part of the sympathetic chain on both sides, their ganglia, the rami communicantes, the origin, course and exit of splanchnic nerves from thorax are dissected out with care, coloured with yellow and studied in detail which has been photographed and tabulated. Results: Stellate ganglion was found in six sides. In two other sides 10 ganglia was found. Marked variations among the pattern of origin of Greater Splanchnic Nerve (GSN) with 14 different categories, Lesser Splanchnic Nerve (LSN) with seven different categories and Least Splanchnic Nerve (LeSN) with five different categories were observed in the present study. Also, the presence of two grey rami communicantes to the eleventh intercostal nerve and no grey ramus for subcostal nerve were observed. Conclusion: The knowledge about the variations of the sympathetic chain, the number of ganglia present, the marked variations about the uncommon origin of splanchnic nerves provided with the current study are all important for the clinicians, surgeons to correlate for various surgical procedures required for the treatment of palmar hyperhidrosis, craniofacial hyperhidrosis, chronic pancreatitis and carcinomas of the pancreas, liver, gall bladder and stomach.
Authors and Affiliations
Thangaraj SP, Nagarajan Vishali
Keywords
Related Articles
- EP ID EP529907
- DOI 10.7860/IJARS/2018/34382:2378
- Views 128
- Downloads 0
Role of MDCT in Oncological Emergencies in a Tertiary Care Oncological Centre
ABSTRACT Introduction: With increasing incidence of cancer in the general population along with improved treatment and better survival, many patients may need urgent care during the course of the disease and treatment. I...
Mandibular Third Molars and Their Influence on Mandibular Angle Fracture Fixation
ABSTRACT Introduction: Mandibular fractures occur commonly in Singapore and 32% involve the angle. The third molar (M3) predisposes the angle to fracture and is often involved in the fracture site. During fixation, it is...
CT Guided Transthoracic FNAC of Intrathoracic Lesions-An Institute Experience
Introduction: In the management of thoracic lesions, especially malignant lesions, specific pathological diagnosis is considered standard, so obtaining the tissue is essential for diagnosis and treatment. There are compl...
Anatomical Variations in the Division and Innervation of the Sciatic Nerve with its Clinical Consequences
ABSTRACT Introduction: Commonly encountered peripheral nerve in emergency, trauma, routine surgical medical practice and neurology is Sciatic Nerve (SN). Its vulnerability to injury is because of its thickness and long c...
Spectrum of Radiological Findings in Leptospirosis on Chest Radiograph and Ultrasonography-Study during Epidemics in South Gujarat Region of India
Introduction: Leptospirosis is an acute generalised infectious disease caused by any of the group of spirochetes of the genus Leptospira. The disease can involve many organs mainly liver, central nervous system, kidneys,...