Saleh Alhasan Faculty of Surgery, Department of General Surgery, Farwanijah Hospital, Sabah Alnasser, Block 6, PO Box 13373 Farwaniya 81004, Kuwait., India
Hamad Alajmi Consultant General Surgeon, Ministry of Health, Kuwait, India
Samy Magdy Faculty of Surgery, Department of General Surgery, Farwanijah Hospital, Sabah Alnasser, Block 6, PO Box 13373 Farwaniya 81004, Kuwait, India
Address for correspondence: Saleh Alhasan, Faculty of Surgery, Department of General Surgery, Farwanijah Hospital, Sabah Alnasser, Block 6, PO Box 13373 Farwaniya 81004, Kuwait., India E-mail: null
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Alajmi H, Magdy S, Alhasan S. A case report of a left long leaf of a bifid xiphisternum misdiagnosed intraoperatively as a xeno-osteum and iatrogenically excised. Indian J Anat. 2023;12(1):37–40.
Timeline
Received : January 10, 2023
Accepted : January 27, 2023
Published : February 28, 2023
Abstract
Anatomical variations and aberrations represent an ever-present challenge to clinicians in general and surgeons in particular. This is particularly true if the variation is rare and the clinical context doesn’t permit a thorough investigation, such as would happen intraoperatively. The unfamiliarity with abnormal anatomy and contextual time constraints may preclude their timely recognition, which may result, subsequently in significant morbidity. The shifting paradigms in anatomy education in both undergraduate and residency medical programs may be linked to an increasingly cited “abnormal anatomy “as a cause for morbidity and mortality in litigious literature. Therefore, Continuous, and self-directed learning, in the face of diminished formal anatomy curricula, is essential to achieving this end. In this case report we describe an incident of iatrogenic excision of a leaf of a bifid xiphisternum mistaken for a migrated ingested bone and the clinical lessons imparted from it. We also provide a relevant literature review.
2. Vatzia K, Fanariotis M, Makridis K, Vlychou M, Fezoulidis I. Frequency of sternal variations and anomalies in living individuals evaluated by MDCT. Eur J Radiol. 2021;142:109828.
4. Kirum GG, Munabi IG, Kukiriza J, Tumusiime G, Kange M. Anatomical variations of the sternal angle and anomalies of adult human sterna from the Galloway osteological collection at Makerere University Anatomy Department. Folia Morphol (Warsz). 2017;76(4):689–94.
5. Macaluso PJ, Lucena J. Morphological variations of the anterior thoracic skeleton and their forensic significance: radiographic findings in a Spanish autopsy sample. Forensic Sci Int. 2014;241:220.e1–220.e7.
6. Akin K, Kosehan D, Topcu A, Koktener A. Anatomic evaluation of the xiphoid process with 64-row multidetector computed tomography. Skeletal Radiol. 2011;40(4):447–52.
7. Standring S, editor. Gray's Anatomy: The Anatomical Basis of Clinical Practice. 41st ed. Edinburgh: Churchill Livingstone; 2015.
8. Mashriqi F, D'Antoni AV, Tubbs RS. Xiphoid process variations: a review with an extremely unusual case report. Cureus. 2017;9(8):e1613.
9. Turkay R, Inci E, Ors S, Nalbant M, Gurses I. Frequency of sternal variations in living individuals. Surg Radiol Anat. 2017;39(11):1273–8.
10. Yekeler E, Tunaci M, Tunaci A, Dursun M, Acunas G. Frequency of sternal variations and anomalies evaluated by MDCT. AJR Am J Roentgenol. 2006;186(4):956–60.
11. Xie YZ, Wang BJ, Yun JS, Chung GH, Ma ZB. Morphology of the human xiphoid process: dissection and radiography of cadavers and MDCT of patients. Surg Radiol Anat. 2014;36(3):209–17.
12. Romero-Reverón R. Venezuelan surgeons' view concerning teaching human anatomical dissection. Anat Cell Biol. 2017;50(1):12–3.
13. Sheikh AH, Barry DS, Gutierrez H, Cryan JF, O'Keeffe GW. Cadaveric anatomy in the future of medical education: what is the surgeons' view? Anat Sci Educ. 2016;9(2):203–8.
14. Turney BW. Anatomy in a modern medical curriculum. Ann R Coll Surg Engl. 2007;89(2):104–7.
15. Kirum GG, Munabi IG, Kukiriza J, Tumusiime G, Kange M. Anatomical variations of the sternal angle and anomalies of adult human sterna from the Galloway osteological collection at Makerere University Anatomy Department. Folia Morphol (Warsz). 2017;76(4):689–94.
Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
Whether all authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
Conflicts of Interest
The authors report no conflicts of interest in this work.
About this article
Cite this article
Alajmi H, Magdy S, Alhasan S. A case report of a left long leaf of a bifid xiphisternum misdiagnosed intraoperatively as a xeno-osteum and iatrogenically excised. Indian J Anat. 2023;12(1):37–40.
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.