Comparison of major anatomical structures of thoracoabdominal region with surface anatomy in children

Accurate knowledge of surface anatomy is important for physical examination of patients, invasive procedures, and surgery. We aimed to determine the association of major anatomical structures of the thorax and the abdomen with surface anatomy in children. A total of 129 abdominal and 127 thoracic computer tomography scans belonging to healthy children aged 0-18 were analyzed. Patients were divided into 5 groups according to age. Surface anatomy of major vascular structures in the thorax and the abdomen, the kidneys, the spleen, the heart, the lungs, the diaphragm, and anatomical planes were determined. In the oldest group, truncus coeliacus, a.mesenterica superior, bifurcatio aortae, and a.renalis sinistra were found at a lower level. Formation of v.cava inferior was found closer to the planum medianum(PM) in the youngest group. The position of right kidney was found between T12-L3 levels and of left was found at T11-L3 levels. The right hilum renalis(HR) was found at L2 and the left was at L1 and L2 levels. The spleen was at the costa VIII-XI levels and anteriorly to linea axillaris mediana. HR and fundus vesicae felleae were below the planum transpyloricum and bifurcatio aortae was above the planum supracristale. Vv. brachiocephalicae formed lateral to art.sternoclavicularis(Art.SC) in younger ages, while they formed posterior to it in older ages. V.cava superior formed at the levels of Art.SC and cartilago costalis(CC) I and merged with the atrium dextrum at levels of spatium intercostale(Sİ) II -CC III. Apex cordis was found at Sİ IV-Sİ V levels. Distance of apex cordis to the PM were ranged between 4,7-7,6 cm in age groups. In all age group, foramen venae cavae was found at lower than T8 level and hiatus aorticus was at T12 level. Hiatus oesophageus was found at above T10 level in 0-7 years. We think that our findings will contribute to physical examination of the spleen and the heart, diagnosing diaphragmatic eventrations, invasive procedures such as central venous catheterization, chest tube insertion and procedures in pediatric urology. Keywords: Pediatric anatomy, Surface anatomy, Thorax, Abdomen, Radiologic anatomy