Comprehensive study of pulmonary hilam with its clinical correlation

Awareness of pulmonary hilar variations is essential for lobectomy of lung.

We studied 54 left and 49 right hilum of formalin fixed adult cadaveric lungs. Morphologic and mophometric details were recorded and variations were noted.

Classical picture of hilum was found in 35.19% left lung and 40.82% right lung. Morphological variations were more on left side (64.81%) than right side (59.18%) in terms of numbers of structures. On the left side, highest percentage of variable structure was bronchus (46.3%) followed by pulmonary artery (37.31%) and lowest by pulmonary vein (31.48%) whereas on right side, percentage for variable pulmonary artery and vein were same (36.73%) followed by bronchi (20.41%). Maximum number of pulmonary veins was five, pulmonary artery was three and accessory bronchus was two on both side hila. In morphometric measurement, mean vertical length of hilum was more on right side whereas anteroposterior length was more on left side. Right hilum is slightly lower and anteriorly placed than left hilum in the mediastinal surface of lung. Significant correlations between vertical length of lung and hilum and antero-postero length of lung and hilum of left and right sides were found.

By analysis and comparison with previous studies, present study concludes that morphology of pulmonary hila is extremely variable which contributes significant consequences in the field of pulmonary resection.