Cadaveric Study of Lung Anatomy: A Surgical Overview

Background: Thorough knowledge of variations in lung anatomy is of prime significance during surgical procedures of lungs. Arrangement of structures in lung hilum act as a guide in performing such procedures. Normal pattern of arrangement of hilar structures in right lung is eparterial bronchus, pulmonary artery, hyparterial bronchus and pulmonary veins from above downwards. In left lung it is pulmonary artery, principal bronchus and pulmonary vein from above downwards. Arrangement of hilar structures from anterior to posterior in both lungs is pulmonary vein, pulmonary artery and principal bronchus. Aim: To report variations in hilar anatomy (arrangement and number) of lungs. Methods and Material: 75 adult formalin fixed cadaveric lungs from department of Anatomy AIIMS New Delhi were observed for variations in lobar anatomy. Arrangement of pulmonary hilar structures observed and variations recorded. Results: Among 75 adult lung specimens observed, 36 were right and rest left lung. Normal pattern of arrangement of hilar structures was seen in 22 right and 23 left lungs. Rest of the lung specimens (14 Right and 16 Left) showed variations in hilar anatomy. Some of them showed alterations in sequence of arrangement of pulmonary artery, pulmonary veins, bronchus and others in number of these structures. Seven right lung specimens showed only 2 lobes with an oblique fissure dividing them and one left lung showed 3 lobes. Conclusion: Alterations in pattern of arrangement of structures in lung hilum are quite frequent. A compromise in knowledge of such variations will result in inadvertent intraoperative complications