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Adrenal Anatomy

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21. Anatomical Variations of the Venous Drainage from the Left Adrenal Gland: An Anatomical Study. (Abstract)

concerning the left adrenal vein (LAV) and its potential anastomosis with the reno-lumbo-azygo trunk (RLAT) and the diaphragmatic circulation.Between November 2014 and October 2015 in the LADAF (French Alps Anatomy Laboratory), we dissected 44 formalin-fixed adult cadavers.We found no direct anastomosis between the left adrenal vein and the reno-azygo-lumbar trunk and two anastomoses (4.5%) between the adrenal capsular vein and azygos system. A lumbo-azygo trunk has been found 38 times (86.3%), drained (...) Anatomical Variations of the Venous Drainage from the Left Adrenal Gland: An Anatomical Study. For radiologists, the venous drainage of adrenal glands is a key to the technique of selective adrenal venous sampling. For endocrine surgeons, it is key to adrenalectomy for carcinoma and pheochromocytoma. This study aims to demonstrate direct anastomosis between the left adrenal vein, the diaphragmatic circulation and the azygos system. Anatomical textbooks only offer very little information

2016 World Journal of Surgery

22. Posterior retroperitoneoscopic approach to the adrenal arteries. (Full text)

, which focuses on surgical anatomy of adrenal arteries when approached during a posterior retroperitoneoscopic adrenalectomy. Details about relative positions between adrenal arteries and adjacent structures are considered and shown during their dissection.The posterior retroperitoneoscopic approach offers a direct view of adrenal arteries and allows for their exposure and safe division in the early steps of adrenalectomy. (...) Posterior retroperitoneoscopic approach to the adrenal arteries. Differently from transperitoneal adrenalectomy, with the posterior retroperitoneoscopic approach adrenal arteries are dissected first [1, 2]. Knowledge of their position is pivotal as they are covered by peri-adrenal fat [3, 4].Four posterior retroperitoneoscopic adrenalectomies were selected, in which adrenal arteries are dissected to show their path and how they can be localized among peri-adrenal fat.A video is presented herein

2016 Surgical endoscopy PubMed abstract

23. Suprarenal fixation resulting in intestinal malperfusion after endovascular aortic aneurysm repair (Full text)

Suprarenal fixation resulting in intestinal malperfusion after endovascular aortic aneurysm repair Superior mesenteric artery (SMA) and coeliac axis (CA) occlusion after endovascular abdominal aneurysm aortic repair (EVAR-AAA), using endograft with suprarenal fixation, are uncommon. However, we are reporting a case of visceral malperfusion, which occurred 7 days after successful EVAR with suprarenal fixation for symptomatic AAA. Endograft metal stent barbs caused severe stenosis of SMA and CA (...) . A successful recovery of SMA was carried out by means of a balloon-expandable stent released through bare metal stent barbs. We believe that an unfavourable anatomy of a proximal aortic neck and visceral aorta may have caused a wrong stent strut deployment with the coverage of CA and SMA.© The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

2016 Interactive cardiovascular and thoracic surgery PubMed abstract

24. The morphology of the adrenal gland in the European bison (Bison bonasus) (Full text)

The morphology of the adrenal gland in the European bison (Bison bonasus) The anatomy of the adrenal glands has been widely studied in many species of domestic and wild mammals. However, there are no available literature reports describing the morphology and morphometry of the adrenal glands of the European bison (Bison bonasus).The study was conducted on 97 European bison of both sexes. The growth of the adrenal glands corresponded to the growth of the whole body, with the largest increase (...) in size occurring in the first 2 years of the animal's life, followed by a slower increase in size until the animal was 5-7 years old. There were no statistically significant differences between ipsilateral adrenal glands of males and females with respect to age. There was no statistically significant difference in weight between the left and the right adrenal gland. However, there was a difference in the length, width and thickness of the two glands. Reference intervals for adrenal gland size

2016 BMC veterinary research PubMed abstract

25. Performance of the Endurant stent graft in challenging anatomy. (Full text)

Performance of the Endurant stent graft in challenging anatomy. This study aimed to compare perioperative and postoperative outcomes after endovascular repair of abdominal aortic aneurysms (AAAs) in patients with various neck morphologic features.Data from the Endurant Stent Graft Natural Selection Global Postmarket Registry (ENGAGE) were used for the analyses. Patients were categorized into three different groups according to proximal aortic neck anatomy: regular (REG), intermediate (INT (...) ), and challenging (CHA). REG was defined as AAAs with a proximal neck ≥15 mm combined with a suprarenal angulation (α) ≤45 degrees and an infrarenal neck angulation (ß) ≤60 degrees. INT was defined as AAAs with a proximal neck of 10 to 15 mm combined with α ≤45 degrees and ß ≤60 degrees or with a proximal neck of >15 mm combined with α ≤60 degrees and ß = 60 to 75 degrees or α = 45 to 60 degrees and ß ≤75 degrees. CHA was defined as infrarenal necks that exceed at least one of the three defining factors.Overall

2015 Journal of Vascular Surgery PubMed abstract

26. Should we question early feminizing genitoplasty for patients with congenital adrenal hyperplasia and XX karyotype? (Abstract)

Should we question early feminizing genitoplasty for patients with congenital adrenal hyperplasia and XX karyotype? There is a wide difference of opinion between the medical-surgical community and advocacy group regarding Disorders of Sexual Development (DSD) secondary to congenital adrenal hyperplasia (CAH) being ranked in the intersex category. This rupture is even more evident when the issue of genitoplasty is brought up. For physicians it is obvious and unequivocal that a person with CAH (...) sex assignment seems legitimate according to this study and the development of gender identity in these patients matches the sex assigned at birth. Resolving early on the adequacy of the genital anatomy with the sex assigned is promoted by patients as well as their parents. Proper psychomotor development and sexual satisfaction underline the absence of complications related to the surgical technique and the relevance of early surgical management.Copyright © 2016 Elsevier Inc. All rights reserved.

2015 Journal of Pediatric Surgery

27. Height augmentation in 11β-hydroxylase deficiency congenital adrenal hyperplasia (Full text)

stage III - IV genital anatomy. Bone age was significantly advanced, yielding a severely compromised predicted final adult height. Biochemical evaluation was consistent with 11β-hydroxylase deficiency congenital adrenal hyperplasia.In an attempt to improve final height, in addition to glucocorticoid replacement, this patient was treated with recombinant growth hormone and a third generation aromatase inhibitor (Letrozole) with an improvement in final height attained as compared with predicted (...) Height augmentation in 11β-hydroxylase deficiency congenital adrenal hyperplasia 11β-hydroxylase deficiency is the second most common form of congenital adrenal hyperplasia. Untreated, this enzyme deficiency leads to virilization, hypertension, and significant height impairment.We describe a patient from abroad who first presented to us at age 7 years for follow-up of ambiguous genitalia. He had been investigated and treated in Pakistan at 3-years-of-age following presentation for bilateral

2015 International journal of pediatric endocrinology PubMed abstract

28. Electron microscopic observation on the adrenal medulla and extra-adrenal chromaffin tissue of the postnatal rabbit. (Full text)

Electron microscopic observation on the adrenal medulla and extra-adrenal chromaffin tissue of the postnatal rabbit. 5442222 1970 06 17 2018 11 13 0021-8782 106 Pt 2 1970 Mar Journal of anatomy J. Anat. Electron microscopic observation on the adrenal medulla and extra-adrenal chromaffin tissue of the postnatal rabbit. 213-31 Coupland R E RE Weakley B S BS eng Journal Article England J Anat 0137162 0021-8782 X4W3ENH1CV Norepinephrine YKH834O4BH Epinephrine IM Adrenal Medulla cytology Age Factors

1970 Journal of anatomy PubMed abstract

29. Electron microscopic observations on the structure of the rat adrenal medulla: I. The ultrastructure and organization of chromaffin cells in the normal adrenal medulla (Full text)

Electron microscopic observations on the structure of the rat adrenal medulla: I. The ultrastructure and organization of chromaffin cells in the normal adrenal medulla 14330730 1996 12 01 2018 12 01 0021-8782 99 1965 Apr Journal of anatomy J. Anat. (ELECTRON MICROSCOPIC OBSERVATIONS ON THE STRUCTURE OF THE RAT ADRENAL MEDULLA. I. THE ULTRASTRUCTURE AND ORGANIZATION OF CHROMAFFIN CELLS IN THE NORMAL ADRENAL MEDULLA.) 231-54 COUPLAND R E RE eng Journal Article England J Anat 0137162 0021-8782 OM (...) Adrenal Medulla Animals Blood Vessels Cell Physiological Phenomena Chromaffin Cells Chromaffin System Cilia Electrons Endoplasmic Reticulum Golgi Apparatus Histology Microscopy Microscopy, Electron Mitochondria Rats Research ADRENAL MEDULLA BLOOD VESSELS CELL STRUCTURE CHROMAFFIN SYSTEM CILIA ENDOPLASMIC RETICULUM EXPERIMENTAL LAB STUDY GOLGI APPARATUS HISTOLOGY MICROSCOPY, ELECTRON MITOCHONDRIA RATS 1965 4 1 1965 4 1 0 1 1965 4 1 0 0 ppublish 14330730 PMC1261389 J Ultrastruct Res. 1961 Oct;5:453-67

1965 Journal of anatomy PubMed abstract

30. Adrenal Adenoma (Overview)

Adrenal Adenoma (Overview) Adrenal Incidentaloma: Background, Anatomy, Pathophysiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE2NTg3LW92ZXJ2aWV3 processing > Adrenal Incidentaloma Updated: Feb 12, 2018 (...) is surgery. The treatment for a malignancy depends on the cell type, spread, and location of the primary tumor. [ ] Nonfunctional adrenal cortical adenomas are not premalignant, and surgical excision is not indicated. (See Treatment and Management.) Next: Anatomy The adrenal glands are located in the perirenal space near the upper pole of each kidney. Their appearance varies: they may be shaped like the letter H, L, Y, T, or V. Typically, they are less than 4 cm in length and less than 1 cm in width

2014 eMedicine.com

31. Adrenal Surgery (Overview)

Before describing surgical technique, understanding the anatomy of the adrenal glands is essential. The adrenal glands, also known as suprarenal glands, belong to the endocrine system. They are a pair of triangular-shaped glands, each about 2 in. long and 1 in. wide. The suprarenal glands are responsible for the release of hormones that regulate metabolism, immune system function, and the salt-water balance in the bloodstream; they also aid in the body’s response to stress. Both adrenals are located (...) about the relevant anatomy, see . Previous Next: Contraindications Metastatic disease, unless part of research protocol, is a contraindication to adrenal surgery. Previous References Mayo CH. Paroxysmal hypertension with tumor of the retroperitoneal nerve. JAMA . 1927. 89:1047. Crout JR, Pisano JJ, Sjoerdsma A. Urinary excretion of catecholamines and their metabolites in pheochromocytoma. Am Heart J . 1961 Mar. 61:375-81. . Nitschke R, Smith EI, Shochat S, et al. Localized neuroblastoma treated

2014 eMedicine.com

32. Adrenal Hemorrhage

% of random autopsies. The rate is likely as high as 26% of patients dying from severe thoracolumbar injuries. The frequency of adrenal insufficiency after adrenal hemorrhage has been estimated to range up to 50% of cases. [ ] No racial or sexual predilection is reported. Pathophysiology and anatomy The precarious blood supply of the adrenal gland makes it very vulnerable to hemorrhage. Several dozen branches from the 3 main adrenal arteries form a subcapsular plexus that drains into the medullary (...) be preceded by serologic studies to exclude a functioning tumor. Consider confirmatory scintigraphic imaging or biopsy in a young child if neuroblastoma is in the differential diagnosis of a suprarenal mass; calcifications have been reported in both entities. Note that the identification of calcifications in an adrenal mass should not unduly influence the decision to sample for tissue, because neuroblastomas commonly calcify. Next: Radiography Plain radiographic film images often are obtained to evaluate

2014 eMedicine Radiology

33. Adrenal Surgery (Diagnosis)

Before describing surgical technique, understanding the anatomy of the adrenal glands is essential. The adrenal glands, also known as suprarenal glands, belong to the endocrine system. They are a pair of triangular-shaped glands, each about 2 in. long and 1 in. wide. The suprarenal glands are responsible for the release of hormones that regulate metabolism, immune system function, and the salt-water balance in the bloodstream; they also aid in the body’s response to stress. Both adrenals are located (...) about the relevant anatomy, see . Previous Next: Contraindications Metastatic disease, unless part of research protocol, is a contraindication to adrenal surgery. Previous References Mayo CH. Paroxysmal hypertension with tumor of the retroperitoneal nerve. JAMA . 1927. 89:1047. Crout JR, Pisano JJ, Sjoerdsma A. Urinary excretion of catecholamines and their metabolites in pheochromocytoma. Am Heart J . 1961 Mar. 61:375-81. . Nitschke R, Smith EI, Shochat S, et al. Localized neuroblastoma treated

2014 eMedicine.com

34. Adrenal Adenoma (Diagnosis)

Adrenal Adenoma (Diagnosis) Adrenal Incidentaloma: Background, Anatomy, Pathophysiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE2NTg3LW92ZXJ2aWV3 processing > Adrenal Incidentaloma Updated: Feb 12, 2018 (...) is surgery. The treatment for a malignancy depends on the cell type, spread, and location of the primary tumor. [ ] Nonfunctional adrenal cortical adenomas are not premalignant, and surgical excision is not indicated. (See Treatment and Management.) Next: Anatomy The adrenal glands are located in the perirenal space near the upper pole of each kidney. Their appearance varies: they may be shaped like the letter H, L, Y, T, or V. Typically, they are less than 4 cm in length and less than 1 cm in width

2014 eMedicine.com

35. Congenital Adrenal Hyperplasia (Follow-up)

final adult height, which is well below that of his mother. Growth hormone in combination with GnRH agonist therapy may improve adult height. [ , ] Female patients with virilizing forms of adrenal hyperplasia have a decreased fertility rate. [ ] The reasons are believed to be multifactorial and include abnormal genital anatomy, vaginal stenosis, and poor control of adrenal androgen production that results in diminished ovulation. When pregnancy does occur, the baby is generally born by means (...) Congenital Adrenal Hyperplasia (Follow-up) Congenital Adrenal Hyperplasia Treatment & Management: Medical Care, Surgical Care, Consultations Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTE5MjE4LXRyZWF0bWVudA

2014 eMedicine Pediatrics

36. Congenital Adrenal Hyperplasia (Overview)

(eg, mixed gonadal dysgenesis, Denys-Drash syndrome) Urogenitography is often helpful in defining the anatomy of the internal genitalia A bone-age study is useful in evaluating for advanced skeletal maturation in a child who develops precocious pubic hair, clitoromegaly, or accelerated linear growth Other tests A karyotype is essential in an infant with ambiguous genitalia, to establish the chromosomal sex Genetic testing is essential for genetic counseling and prenatal diagnosis of adrenal (...) Congenital Adrenal Hyperplasia (Overview) Congenital Adrenal Hyperplasia: Practice Essentials, Background, Pathophysiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTE5MjE4LW92ZXJ2aWV3 processing

2014 eMedicine Pediatrics

37. Congenital Adrenal Hyperplasia (Treatment)

final adult height, which is well below that of his mother. Growth hormone in combination with GnRH agonist therapy may improve adult height. [ , ] Female patients with virilizing forms of adrenal hyperplasia have a decreased fertility rate. [ ] The reasons are believed to be multifactorial and include abnormal genital anatomy, vaginal stenosis, and poor control of adrenal androgen production that results in diminished ovulation. When pregnancy does occur, the baby is generally born by means (...) Congenital Adrenal Hyperplasia (Treatment) Congenital Adrenal Hyperplasia Treatment & Management: Medical Care, Surgical Care, Consultations Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTE5MjE4LXRyZWF0bWVudA

2014 eMedicine Pediatrics

38. Adrenal Insufficiency (Diagnosis)

Adrenal Insufficiency (Diagnosis) Pediatric Adrenal Insufficiency (Addison Disease): Practice Essentials, Anatomy, Etiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTE5MDc3LW92ZXJ2aWV3 processing (...) (Adrenal Insufficiency). Next: Anatomy The adrenal cortex is divided into 3 major anatomic zones. The zona glomerulosa produces aldosterone, and the zonae fasciculata and reticularis together produce cortisol and adrenal androgens. A fetal zone, unique to primates, produces dehydroepiandrosterone (DHEA), a precursor of both androgens and estrogens. This zone involutes within the first few months of postnatal life. Aldosterone secretion is primarily regulated by the renin-angiotensin system. Increased

2014 eMedicine Pediatrics

39. Adrenal Glands (Diagnosis)

Updated: Feb 20, 2018 Author: Saundra M Kay, MD, FRCSC; Chief Editor: Eugene S Kim, MD, FACS, FAAP Share Email Print Feedback Close Sections Sections Pediatric Adrenal Gland Disorders Anatomy The adrenal (suprarenal) glands are small, yellowish organs that rest on the upper poles of the kidneys in the Gerota fascia. The right adrenal gland is pyramidal, whereas the left one is more crescentic, extending toward the hilum of the kidney. At age 1 year, each adrenal gland weighs approximately 1 g (...) Adrenal Glands (Diagnosis) Pediatric Adrenal Gland Disorders: Anatomy, Embryology, Physiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTQwMzQ3LW92ZXJ2aWV3 processing > Pediatric Adrenal Gland Disorders

2014 eMedicine Pediatrics

40. Adrenal Glands (Follow-up)

Updated: Feb 20, 2018 Author: Saundra M Kay, MD, FRCSC; Chief Editor: Eugene S Kim, MD, FACS, FAAP Share Email Print Feedback Close Sections Sections Pediatric Adrenal Gland Disorders Anatomy The adrenal (suprarenal) glands are small, yellowish organs that rest on the upper poles of the kidneys in the Gerota fascia. The right adrenal gland is pyramidal, whereas the left one is more crescentic, extending toward the hilum of the kidney. At age 1 year, each adrenal gland weighs approximately 1 g (...) Adrenal Glands (Follow-up) Pediatric Adrenal Gland Disorders: Anatomy, Embryology, Physiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvOTQwMzQ3LW92ZXJ2aWV3 processing > Pediatric Adrenal Gland Disorders

2014 eMedicine Pediatrics

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