Unveiling Hidden Variations in Lung Fissures: A Cadaveric Perspective on Surgical and Diagnostic Challenges

Introduction Anatomical variations in lung fissures arise from incomplete obliteration of intersegmental planes during embryogenesis, resulting in incomplete, accessory, or absent fissures. These variants pose challenges in thoracic surgery, increasing risks of air leaks, prolonged operative times, and conversion to thoracotomy, while complicating radiological interpretation. Materials and methods This descriptive cross-sectional study aimed to characterise the patterns and completeness of major lung fissures in adult cadaveric lungs and to compare these features between the right and left sides. Sixty unpaired adult cadaveric lungs (30 right, 30 left) were examined in the Department of Anatomy, Smt. B. K. Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth Deemed to Be University, Vadodara, Gujarat, India. Each lung was examined for fissure number, completeness, accessory fissures, and lobar demarcation. Fissure completeness was classified using the Craig and Walker grading system (Grade I-IV), with findings recorded and photographically documented. Results Of 30 right lungs, 19 (63.3%) showed normal fissure patterns while 11 (36.7%) exhibited abnormalities. Of the 30 left lungs, 25 (83.3%) were normal, and five (16.7%) showed abnormal morphology. The difference in normal fissure prevalence between sides was not statistically significant (p = 0.143, Fisher's exact test). Complete oblique fissures were present in all right lungs but in 83.3% of left lungs (p = 0.052). Conclusion Cadaveric lungs demonstrate notable fissural variation, with abnormalities more frequent in the right lungs. Recognition of graded fissure completeness is essential for surgeons and radiologists to optimise preoperative planning and minimise complications.