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Reappraisal of the classical abdominal anatomical landmarks using in vivo computerized tomography imaging

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Abstract

Introduction

With expanding scope of interventions it becomes mandatory to have correct and evidence-based knowledge of surface anatomy of internal abdominal structures. Information available in text books is derived from work done on cadaveric studies. Current study was designed to provide data of key abdominal surface anatomical landmarks and their variations in living subjects using CT imaging of adult population.

Materials and methods

Cross-sectional study was conducted using 100 abdominopelvic CT scans of patients of Indian origin.

Results

Vertebral levels of origin of celiac trunk varied from T11 to L1/2 intervertebral disc, superior mesenteric artery from T12 to L2, inferior mesenteric artery from L2 to L4 and aortic bifurcation from L3 to L5. Origin of both renal arteries varied between T12 and L2 and the formation of inferior vena cava varied from L3 to L5. Vertebral levels of upper pole of both kidneys ranged from T11 to upper L3. Spleen was related to 9th to 11th ribs in 36% and 10th to 12th ribs in 34% scans. Most common vertebral levels of subcostal plane, planum supracristale and planum intertuberculare noticed were lower L2, L4 and lower L5, respectively.

Conclusions

Data derived from imaging investigations of living subjects and variations from the conventional descriptions observed in the current study might be helpful for clinicians.

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Acknowledgements

The authors thank the individuals whose data have been used in the study for the advancement in anatomical knowledge.

Funding

This study has not received any funding.

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Authors and Affiliations

  1. Department of Anatomy, PGIMER, #123-c Type V Flats, Sector 24 A, Chandigarh, 160023, India

    Ruchi Goyal, Anjali Aggarwal, Tulika Gupta & Daisy Sahni

  2. Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh, 160012, India

    Ajay Gulati & Shallu Jaggi

  3. Anatomy and Medical Imaging Department, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Victoria Street West, Auckland, New Zealand

    S. Ali Mirjalili

Authors
  1. Ruchi Goyal
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  2. Anjali Aggarwal
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  6. S. Ali Mirjalili
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  7. Daisy Sahni
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Contributions

RG data collection, manuscript writing. AA designed the study, manuscript writing and editing. TG manuscript writing and editing. AG data collection and standardisation of software used in the study. SJ statistical analysis. SAM designed the study. DS read and approved the final manuscript.

Corresponding author

Correspondence to Anjali Aggarwal.

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Conflict of interest

The authors report no conflict of interest concerning the materials and methods used in this study or the findings specified in this report.

Ethical standards

This study was approved by the Institutional ethical committee (No: NK/3654/Study/561).

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Goyal, R., Aggarwal, A., Gupta, T. et al. Reappraisal of the classical abdominal anatomical landmarks using in vivo computerized tomography imaging. Surg Radiol Anat 42, 417–428 (2020). https://doi.org/10.1007/s00276-019-02326-4

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  • DOI: https://doi.org/10.1007/s00276-019-02326-4

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