Ectopic Organs PDF

Ectopic organs  Objectives At the end of this presentation students should be able to: Give the meaning of ectopic, and state its consequences for positioning in Radiography Identify different circumstances in which ectopic organs may occur with reference to the normal...

Ectopic organs  Objectives At the end of this presentation students should be able to: Give the meaning of ectopic, and state its consequences for positioning in Radiography Identify different circumstances in which ectopic organs may occur with reference to the normal positions of organs.  Consider syndromes- where more than one organ occupies an un-expected position.  Introduction While topographical anatomy describes organs in their normal/expected positions, it must be recognised that in rare cases, organs may be sited/located in areas besides those described/expected. In such cases, the organs are said to be ECTOPIC. The word ectopic means: abnormally placed or displaced.  SITUS INVERSUS PARTIALIS This is a syndrome characterised by the following: - apex of heart on the right side (dextrocardia) - Stomach on the right side - Small intestine on the right side - colon on the left side of the abdomen - Caecum in the midline * These features( 2-5) are collectively called mal-rotation of the gut. In extreme cases of situs inversus, the spleen may be found on the right side, the liver on the left. In this case there is full inversion of the gut/ transposition of the viscera.  Dextroposition of the aorta: a/c overriding aorta. Instead of arising solely from the left ventricle, the aorta overrides the interventricular septum, receiving blood from both right and left ventricles. Also sometimes called right to left shunt.  Kidneys: Several varieties of displacement are possible: 1. Pelvic kidneys: One or both kidneys may be found in the pelvis rather than in the usual location between T11- L3 in the upper abdomen. 2. Both kidneys may be found on a single side (right or left either as separate units having separate collecting systems and ureters OR 3.Having both collecting systems and ureters in a single large kidney- i.e. both kidneys are fused into a single unit). Sometimes a single ureter from the large fused unit may cross on to the opposite side entering the urinary bladder on the opposite side where the second kidney should have been located.  Pancreas:There may be deposits of ectopic pancreatic tissues in areas outside of the pancreas: viz Duodenum, stomach, small bowel, biliary ducts, gall bladder, liver, spleen.  Ectopia Vesicae : o/c ectopic urinary bladder. This is a rare anomaly in which as a result of developmental failure, the anterior wall of the urinary bladder and a part of the anterior abdominal wall are absent. The 2 pubic bones are widely separated at the symphysis pubis and the posterior wall of the bladder and urethral orifices lie on the anterior surface of the lower abdomen.  Ectopic pregnancy: o/c extrauterine pregnancy. Fertilization and development of the ovum in a fallopian tube. The ovum becomes embedded in the tube and may end with rupture and haemorrhage into the peritoneal cavity.  Undescended and ectopic testis: The testes develop in the abdomen and descend into the scrotal sac outside of the body, just before birth. However, the testes may remain in the the abdomen ( undescended) or descend to some abnormal position.( ectopic) Undescended or ectopic testes may both occur as unilateral or bilateral abnormalities.  When an undescended testis is retained in the abdomen or the inguinal canal on one or both sides, this condition is called cryptorchidism. Undescended testes require urgent attention during childhood, if descent does not occur spontaneously, as there is an increased risk of malignant change when it remains in the abdomino-pelvic cavity.  Ectopic endometrium: ( endometriosis). This term describes the presence of endometrial tissue in other sites besides the uterine cavity. The sites where it may be found are:( external endometriosis)- uterine tubes and ovaries, intestine, peritoneum, umbilicus) and in the muscular wall of the uterus ( where it is called uterine adenomyosis.)  Endometrial deposits undergo pre-menstrual changes and bleed at the time of the normal menstrual period. They cause intense pain/cramping. It is also associated with menorrhagia.  Prolapse: In gynaecology this means the protrusion of one or more pelvic organs into the vagina or through the pelvic floor. There may be prolapse of other organs such as the urinary bladder ( called cystocoele )or prolapse of the rectum ( called rectocoele)  HERNIATION HIATUS HERNIA: Part of the stomach protrudes upward into the oesophagus UMBILICAL HERNIA: Part of the intestine protrudes into the umbilicus INGUINAL HERNIA: Part of intestine protrudes into the inguinal space.