HRCT evaluation of the accessory fissures of the lung (original) (raw)

Anatomical Variations in Fissure of the Lung on Computed Tomography

Online Turkish Journal of Health Sciences, 2023

Objective: Lung fissures embryologically separate the bronchopulmonary segments from each other. We aimed to detect anatomical variations in fissures in patients who underwent thoracic computed tomography (CT). Materials and Methods: All the patients underwent a thoracic CT examination between July 1-July 15, 2022. The patients' gender, lung fissures continuity, accessory fissures presence, and variation side were recorded. The frequency of fissures was compared between the genders using the chi-square test. Results: The study included a total of 352 patients (211 men, 141 women). A total of 105 variations were detected in 95/352 (26.99%) of the patients, 61/211 (28.91%) were male, 34/141 (24.11%) were female. The right oblique fissure was incomplete in nine (2.6%), and the right horizontal fissure was incomplete in 14 (4%) patients and absent in 14 (4%). The left oblique fissure was observed to be incomplete in 16 (4.5%) patients. A total of 52 (14.8%) accessory fissures were detected. Conclusions: In the literature, a wide variety of fissure variations have been reported. Due to this diversity, having good knowledge of the fissure anatomical architecture is essential when performing surgical procedures and interpreting radiological images to clinically identify the location of bronchopulmonary segments.

Incomplete oblique fissure and accessory fissure of left lung

2015

The anatomical knowledge of the fissures and the lobes of the lungs are important for accurate interpretation on xrays and CT scans. During routine dissection of thorax region for 1st year MBBS students, we found incomplete oblique fissure on the costal surface of the left lung, it coursed normally from the posterosuperior part of the hilum (Just above the gap between the pulmonary artery and left principle bronchus). It crossed the posterior border 4 cm below the apex. It then descends forwards across the costal surface and completed only 2/3 part of the costal surface. Further remaining 1/3 part of the fissure was incomplete up to the lower part of the hilum. On the base there was superficial accessory fissure which was measured 3 cm in length. Knowing the frequency of occurrence of a variant fissure in a particular population might help the radiologist clinicians and surgeons to make correct diagnosis to plan, execute and modify surgical procedures and this may reduce the morbidi...

Absence of Horizontal fissure with bilateral Inferior accessory fissure and accessory fissure on upper lobe of right lung a rare association of fissure pattern, an incidental finding

IP Innovative Publication Pvt. Ltd., 2017

Variation in Lung fissure pattern is reported frequently. During routine dissection hours a case of absence of Horizontal fissure in the right lung was observed, which was associated with inferior accessory fissure and accessory fissure on upper lobe. The left lung had an inferior accessory fissure along with the normal oblique fissure. Such fissure patterns are to be taken into account while interpreting a chest radiograph or surgical intervention of any lung lesion. Introduction The right lung is divided into superior, middle and inferior lobes by its oblique (major) and horizontal (minor) fissures. The left lung is divided by the oblique fissure into upper and lower lobes. The oblique fissure starts on the posterior border at either level with the spine of the fourth thoracic vertebra or slightly lower, then descends across the fifth intercostal space crossing the inferior border of the lung approximately 7.5 cm behind its anterior end. The shorter horizontal fissure separates the superior and middle lobes. It passes from the oblique fissure, near the mid-axillary line, horizontally forwards to the anterior border of the lung, level with the sternal end of the fourth costal cartilage. (1) The more vertical left oblique fissure is approximately indicated by vertebral border of scapula in fully abducted arm. (2) Defective pulmonary development give rise to variations in fissures and lobes. The knowledge of variation of anatomy of fissures of lung helps in radiographic interpretation of different conditions and spread of various diseases through different pathways. (3) We present a unique pattern of fissure association, observed during routine dissection practical.

Accessory Fissure of Right Lung: A Report of Two Cases

2014

Address for Correspondence: Dr. Sarita Behera, Senior Resident/Tutor, Department of Anatomy, V.S.S.Medical College, Burla, Sambalpur, Odisha, India. Phone – 09937105198, 09437218699. E-Mail: drsaritabehera81@gmail.com Access this Article online Quick Response code Web site: *1 Senior Resident/Tutor, 2 Professor, 3 Associate Professor. Department of Anatomy, V.S.S.Medical College, Burla, Sambalpur, Odisha, India. Right lung is divided into upper (superior), middle and lower (Inferior) lobes by an oblique and a horizontal fissure.Oblique fissure passes spirally from posterior border to inferior border deep into the lung separating the lower lobe from upper and middle lobes. A short horizontal fissure passes horizontally forwards from the oblique fissure at midaxillary line to meet the anterior border at 4th costochondral junction. This separates the upper lobe from the middle lobe. During routine dissection in 2010-11 undergraduate batch, we came across two cases of right lungs where ...

Anatomical study on variations of fissures of lung

2016

This study is conducted to record the variations in fissures and lobes of lung which will be helpful for all clinicians and also of academic interest. Materials and Methods: The study was undertaken in 25 pairs of cadaveric specimens. The lungs were exposed to study the morphological features like number, fissures and lobes. Presence of anatomical variations was observed and photographed. Results: 11 right side lungs showed incomplete horizontal fissure. In 5 right lungs there was no horizontal fissure. Incomplete oblique fissure was found in 7 right lungs. 2 right lungs did not have any fissures. 8 left lungs exhibited incomplete oblique fissure. Conclusion: A detailed knowledge of the anatomy of the fissures of lung is essential for the proper interpretation of radiological images like X- ray, CT scan and MRI for the radiologists, cardiothoracic surgeons performing lobectomies, and segmental resections. Furthermore, the knowledge of fissures and lobes of lungs is important for the surgeons to properly manage the potential problems which may be encounterd during surgery.

Variations of Lung Fissures: A Cadaveric Study

Journal of Krishna Institute of Medical Sciences University

Background: The presence of fissures in the normal lungs enhances uniform expansion and hence facilitates more air intake. Accessory and incomplete fissures of varying depth can be seen in unusual locations of the lung, delimiting abnormal lobes which correspond to the normal bronchopulmonary segments. The knowledge of anatomical variations of lung fissures is essential for clinicians, surgeons, and for radiologist for recognizing various images of related abnormalities because an accessory or anomalous fissure can be mistaken for a lung lesion or an atypical appearance of pleural effusion. Aims and Objectives: The aim of the present study is to observe the variations of lung fissures in Indian population. Fifty pairs (right-50; left-50) of lungs were used for this study. Each lung was studied carefully for number of fissures whether complete or incomplete or absent. Presences of accessory fissures were noted. Results: We observed complete absence of fissures in two right and left l...

Morphological Study of Lung Lobes and Fissures: Anatomical Basis of Surgical and Imaging Techniques

International Journal of Anatomy and Research, 2017

Background: A sound knowledge regarding anatomy of the lungs is must for the clinicians. Knowledge of anatomy and normal variants of the major fissures is essential for recognizing their variable imaging appearances as well as related abnormalities. The fissures may be complete or incomplete or it may be absent completely.. In addition to these fissures, lung might also have accessory fissures indicating junctions between bronchopulmonary segments. Sometimes radiologist may misinterpret an X-ray or CT scan. Anatomical knowledge of such variations is helpful for lobectomies and surgical resections involving individual segments. Materials and Methods: 77 lungs from 40 cadavers were included in the study carried out in the dissection hall of our medical college. Morphological features of lung fissures and lobes were noted. Presence of any accessory fissures was also recorded. Results: Incomplete oblique fissure was observed in 10.26% on right side and 5.26% on left side. Oblique fissure was found missing in 2.56% of right lungs. Absent horizontal fissure was observed in 23.08% of right lungs. Conclusions: The knowledge of fissures and lobes of the lung is highly recommended for the clinicians and anatomists as well. CT and other radiological procedures showing fissures of the lung should be interpreted keeping in mind of possible variations of various fissures.

Types of pulmonary fissures and its surgical implications: A cadaveric study

IP innovative publication pvt ltd, 2020

Being the essential organs of respiration, pair of lungs are situated on either side of the mediastinum. Each lung is divided into lobes by the fissures. These fissures allow for proper expansion of lungs and on the other hand fissures may have a role in restricting infection to a particular lobe. Fissures may be complete, incomplete or absent. Objective: To study the variations in the fissures of lung, compare the results with the available data and to discuss the surgical importance of this study. Materials and Methods: 37 pairs of lungs (37 right and 37 left) from formalin fixed cadavers were observed and classified into different grades of fissures ( as per Craig and Walker criteria). Presence of accessory fissures was noted. Results: Out of the 37 right lungs, 3 showed absence of horizontal fissure and the same fissure was incomplete in right sided 17 lungs. Among the left lungs, 9 had incomplete oblique fissure. Accessory fissure were found in 2 right and 1 left lungs. Conclusion: The current study showed that right lung may be without horizontal fissure or fissures may be incomplete. Thus, a light on these variations by the cardiothoracic surgeons will help in better planning of surgeries like lobectomy. Knowledge about the fissures will aid in arriving at better diagnosis for the clinicians and radiologists.

Incomplete Horizontal Fissure of Right Lung -A Case Report

The right lung has two fissures, an oblique and a horizontal, dividing it into three lobes namely the upper, middle and lower. The anomaly of the fissure pattern has been described by many radiologist, whereas, there were only fewer studies on gross anatomical specimens. The present case describes a peculiar incomplete horizontal fissure which started from the oblique fissure but did not traversed backwards towards the medial surface of the lung. Anatomical knowledge of anomalies of fissures and lobes of lungs is important for surgeons performing lobectomies, radiologists interpreting X-ray and CT scans and also of academic interest to all medical personnel. The right lung normally has three lobes namely the upper, middle and lower formed by two fissures; an oblique and a horizontal one (Standring, 2005). The oblique fissure runs downwards, thereby meeting the inferior border of the lung at a distance of approximately 7.5 cm behind anterior end (Standring 2005). The horizontal fissu...

Cadaveric study of morphological variations of fissures and lobes of lungs and their clinical significance

MedPulse International Journal of Anatomy, 2017

Background: Anatomical variations of lungs which include fissures and lobes of lungs are very necessary for the clinicians for recognizing their variable imaging appearances as well as related abnormalities. Aims and Objectives: So present study was undertaken to note such variations and compare these results with the other studies as well as to identify their clinical significance. Methods: For the study 32 pairs of formalin fixed lungs were taken. These specimens were cleaned, fine dissected and thoroughly observed for any variations of the fissures and lobes of the lungs. Variations were noted and photographed. Results: Among the left lungs, 01 showed presence of incomplete oblique fissure while in another lung there was total absence of oblique fissure, although in one lung there was presence of oblique fissure in the middle part of lung on the sternocostal surface. Accessory fissure was seen in 07 lungs. In right lungs 02 had incomplete oblique fissure, while horizontal fissure was incomplete in 12 lungs. 05 lungs were without the horizontal fissure. Accessory fissure was present in 05 lungs. Conclusion: The present results showed variations on the left side in 35.71% of total lungs in the form of incomplete/absent oblique fissure and presence of accessory fissure. On the right side 75% of the total lungs showed variations in the form of incomplete/absence of fissures and presence of incomplete fissures. These results were compared with previous studies n found to be correlated. Knowledge of these variations is important for both the diagnosis and treatment of various diseases of lungs.