The development of the fetal sternum: a cross-sectional sonographic study

Discovery of an Anteriorly Deviated, Partially Ossified Xiphoid Process With a Large, Teardrop-Shaped Foramen in a Male Cadaver

The sternum, or "breastbone," is a principal bony component of the anterior thoracic wall and comprises the manubrium of the sternum, the body of the sternum, and the xiphoid process. The xiphoid process is the most inferior of these elements and commonly presents as a small, solid bone shaped like an inverted triangle. However, clinical literature has reported numerous variations in its size, shape, and presentation, likely the result of its lengthy embryological development from cartilage into fully ossified bone. In this case report, a rare, anteriorly deviated, partially ossified xiphoid process with a large, teardrop-shaped foramen is presented that was discovered during a routine cadaveric dissection of a 75-year-old male within an undergraduate anatomy course. Although anatomical variations in the xiphoid process are often asymptomatic and often only found incidentally through CT or X-ray scans, healthcare professionals should be aware of such variations to avoid both misdiagnoses as well as iatrogenic complications.

[Morphology of sternum for formation of the biological profile of unidentified individual]

Identification of a person by general group characteristics does not lose its relevance over a long period. An analysis of publications (2000-2023) devoted to the possibilities of using the sternum to determine gender and age showed a fairly large amount of work on this topic, with very promising results. The trend in the development of this area is the use of modern methods of medical imaging. This becomes the starting point for conducting such studies on the territory of the Russian Federation and developing a methodology that includes the Russian population, taking into account their population characteristics.

Discordant Anomalies with Combined Features of Pentalogy of Cantrell and OEIS Complex: A Case Report in Monochorionic Twins

INTRODUCTION

Ventral body wall defects have various manifestations. Among others, pentalogy of Cantrell (PC) and omphalocele exstrophy imperforate anus spinal abnormalities (OEIS) complex are defects that involve upper and lower anterior midline of body wall, respectively. Although both entities are in a spectrum of ventral body wall defects, the combination of PC and OEIS complex has not been described.

CASE REPORT

In this report, we describe an unusual case of congenital ventral body wall defect with combined features of PC and OEIS complex, which discordantly occurred in monochorionic monoamniotic twins.

CONCLUSION

PC and OEIS complex may be related regarding their embryologic origins. The combination may represent the most severe manifestation of ventral body wall defects.

Sternal cleft: prenatal multimodality imaging

Sternal clefts have been reported sporadically, but there are no reports describing complete investigations of the malformation. We describe a child with isolated inferior sternal cleft diagnosed at 33 weeks of gestation and thoroughly investigated by prenatal US, MRI and CT and preoperative US. Our report highlights the importance of accurate and in-depth investigation by multimodality imaging that allows detection of accompanying serious anomalies and, hence, forms the basis for informed parental counselling and for postnatal interdisciplinary care.

[Pentalogy of Cantrell: six new cases]

Cantrell's pentalogy is a rare multiple malformation syndrome consisting of supraumbilical abdominal wall defect, sternal defect, pericardial defect, anterior diaphragmatic defect and heart malformation.

AIMS AND METHODS

Prenatal ultrasound findings and malformations described during autopsy of the Cantrell's pentalogy cases diagnosed between January 1991 and June 2009 in our institute were reviewed. A literature research was conducted to analyze the prevalence and prenatal detection rate of the five previously described malformations and ectopia cordis in the Cantrell's pentalogy cases.

RESULTS

Six cases of Cantrell's pentalogy were diagnosed during the study period in our department. Sonography detected multiple malformations in 3 cases, and isolated malformation in 3 cases. Analyzing the data of 49 Cantrell's pentalogy cases altogether showed that, beside abdominal wall defect and ectopia cordis which had the highest prenatal detection rate (83% and 91% with a prevalence of 94% and 69%, respectively), sternal defect and anterior diaphragmatic hernia were also present in a large number of the cases (80% and 73% respectively).

CONCLUSION

Sonographic identification of the sternal defect or diaphragmatic hernia may help to differentiate Cantrell's pentalogy from malformations part of the syndrome but occurring as isolated defects.

Anatomical development of urinary bladder during the fetal period

The aim of this study was to determine the development, location, and size of the urinary bladder during the fetal period. The study was performed on 149 human fetuses between 9 and 40 weeks of gestation. The location of the urinary bladder with respect to transverse plane between the highest point of pubic symphysis and the sacral promontory and median sagittal plane was first determined. The dimensions and the angle of the urinary bladder were measured, and bladder shapes were determined. In addition, the edges of the vesical trigone were measured. There was no significant difference between sexes for any of the parameters (P > 0.05). A significant correlation was observed between all parameters and gestational age (P < 0.001). The urinary bladder was located above the transverse plane in most of the cases (83%) and in the median sagittal plane in every case. It was determined that the angle of bladder did not change and the mean value of the angle was 151 degrees during the fetal period. Bladder was categorized into four different shapes (ellipsoid, round, cuboid, and triangular), and the most common shape found during the fetal period was cuboid. The vesical trigone was an isosceles triangle during the fetal period. The new data provided by this study will enable evaluation of the development of the fetal urinary bladder, and should be useful in several fields such as anatomy, fetopathology, medical imaging, obstetrics, and pediatric urology.

Size and location of the fetal diaphragm during the fetal period in human fetuses

AIM

The aim of this study was to determine the development and the size and localization of the diaphragm during the fetal period in human fetuses.

MATERIALS AND METHODS

One hundred and eighty-four diaphragm obtained from human fetuses aged between 9 and 40 weeks of gestation was used in this study. The localization of the diaphragm with respect to abdominal cavity and the level of costodiaphragmatic recess with respect to the ribs were determined. The dimensions (height, width, and depth) of the diaphragm were measured. The diameter and localization of apertures on the diaphragm were determined.

RESULTS

During the fetal period, the costodiaphragmatic recess was most commonly located at the level of the 9th rib. Means and standard deviations of the all parameters with respect to gestational weeks and months were calculated. No significant differences were observed between sexes for any of the parameters (P > 0.05). All parameters were increasing with age during fetal period. There was significant correlation between gestational age and all parameters (P < 0.001). The localizations of the diaphragmatic apertures did not change throughout the fetal period and aortic hiatus and oesophageal hiatus were most frequently situated to the left of the median plane.

CONCLUSION

New data are derived for human fetuses to evaluate diaphragmatic development. Data acquired in this study are believed to contribute to studies of obstetrics, perinatology, forensic medicine and fetal pathology on fetal development of the diaphragm, and diagnosis of its anomalies, pathologies and variations.

The development of stomach during the fetal period

The objective of this study was to explore the fetal development of the stomach, its morphology and relationship with neighboring structures. The study is carried out in 2003 using 160 human embryos and fetuses (81 males and 79 females) aged between 9 and 40 weeks of gestation. None of the cases had any external pathology or anomaly. Its topographical localization and relationship with surrounding structures were revealed with anatomical dissections. Width and height of the stomach, lengths of the greater and lesser curvatures, the angle between horizontal and vertical axes of the stomach and types of stomach were established. During the fetal life stomach was most commonly located above the transverse axis passing through the umbilicus, in left and right hypochondrium (81%). There were significant differences among trimester groups with respect to the localization of the stomach in the quadrants (P < 0.001). There were no significant sex differences in parameters. After the second trimester, the height of the stomach increased more than the width of the stomach and anterior abdominal height. The angle of stomach decreased from 100 degrees to 50 degrees throughout the fetal period. During the fetal period, wide angles stomach was more common in the first(f) and second trimesters while acute-angled stomach was more common in the third trimester and term fetuses. Diagnosis and treatment of fetal anomalies and pathologies of the stomach requires knowledge of fetal anatomy of the stomach. Data acquired in this study are believed to contribute to the studies of obstetrics, perinatology, forensic medicine and fetal pathology on fetal development of the stomach, and diagnosis and treatment of its anomalies, pathologies, and variations.