解剖学报 ›› 2018, Vol. 49 ›› Issue (5): 657-659.doi: 10.16098/j.issn.0529-1356.2018.05.016

• 解剖学 • 上一篇    下一篇

男性单侧腹直肌罕见缺失变异1例

贾梓淇1 王宇晨1 张妙颜1 赵森1 申新华2* 曹承刚2 马超2*   

  1. 1.北京协和医学院八年制临床医学专业,北京 100005; 2.中国医学科学院基础医学研究所,北京协和医学院基础学院,人体解剖学与组织学胚胎学系,北京 100005
  • 收稿日期:2017-10-19 修回日期:2017-11-06 出版日期:2018-10-06 发布日期:2018-10-06
  • 通讯作者: 申新华;马超 E-mail:Mcpumc@163.com
  • 基金资助:
    人体形态教学中的人文素养培育,北京协和医学院教学改革项目;北京协和医学院教育教学改革项目

 A rare case of unilateral complete absence of rectus abdominis in adult male

JIA Zi-qi1 WANG Yu-chen1 ZHANG Miao-yan1 ZHAO Sen1 SHEN Xin-hua 2* CAO Cheng-gang2 MA Chao 2*   

  1. 1.Eight-Year Medical Education Program, PUMC, Beijing 100005, China; 2.Department of Anatomy, Histology and Embryology, Institute of Basic Medical Sciences, School of Basic Medicine, CAMS & PUMC, Beijing 100005, China
  • Received:2017-10-19 Revised:2017-11-06 Online:2018-10-06 Published:2018-10-06
  • Contact: SHEN Xin-hua; MA Chao E-mail:Mcpumc@163.com

摘要:

目的 报道1例罕见的右侧腹直肌完全缺失并不伴有其他器官系统变异尸体的腹部解剖过程,腹壁肌群及其供血情况。 方法 解剖并观察尸体腹壁肌、血供、神经支配,对比两侧腹直肌发育和形态差异。 结果 该尸体右侧腹直肌缺失,腹直肌鞘完好,腹壁上动脉和腹壁下动脉仍在腹直肌鞘内走行并相吻合,肋间神经及肋下神经(T7~T12)由鞘内穿出达皮下。左侧腹直肌发育正常并有代偿性增生。男尸腹壁未见疤痕和手术切痕,腹内器官无缺失,腹膜除肝区外无黏连。 结论 该尸体右侧腹直肌缺失可能是胚胎发育第6周之前出现异常所导致。目前腹直肌肌皮瓣常用于多项外科重建手术,全面了解腹直肌的相关变异,对于扩展重建手术的应用范围和作好术前准备,确保手术成功均具有指导意义。

关键词: 腹直肌, 变异, 解剖学,

Abstract:

Objective To report a rare case of unilateral complete absence of rectus abdominis muscle in an adult male without any other malformations, and reveal the abdominal dissection process, abdominal wall muscles and their blood supplies. Methods The abdominal wall muscles, their blood supplies, and innervations were dissected and observed. The development and morphology of rectus abdominis on both sides were compared. Results The cadaver had no rectus abdominis muscle on the right side. The superior and inferior epigastric arteries met with each other and remained intact in the substitutional connective tissue within the rectus sheath. The intercostal and subcostal nerves (T7-T12) pierced the sheath and reach the superficial fascia. The left rectus abdominis muscle was complete with compensatory hypertrophy. No scar or signs of surgery were found on the skin. No abdominal organ was absent, and no adhesion was found in the peritoneum except the liver area. Conclusion The absence of right rectus abdominis may result from abnormal embryonic development before the 6th week. Rectus abdominis flaps are used in many surgical reconstruction surgeries. The knowledge of the related mutations is clinically significant for preoperative preparation and the use of rectus abdominis flap.

Key words: Rectus abdominis, Mutation, Anatomy, Human