Distribution and Variability of the Abdominal Vagus Nerve: An Anatomical Study in Uganda

Abstract

Iatrogenic injury to the vagus nerve during gastrointestinal surgery may result in postoperative complications due to disruption of its anti-inflammatory and neuromodulatory functions. Although anatomical variations of the abdominal vagus nerve have been described, data from African populations, particularly Uganda, remain limited. This study aimed to describe the distribution and anatomical variations of the abdominal vagus nerve. This analytical cross-sectional study was conducted on 67 unclaimed postmortem human bodies. Dissections were performed using a standardized protocol, and anatomical findings were recorded using a pretested data collection form. Statistical analysis was performed using STATA version 13.0. The principal nerve of Latarjet was identified in 83.6 % of specimens, and a crow’s foot pattern was observed in 80 %. A single hepatic branch was present in all specimens, while an anterior vagal plexus was identified in 32.8 %. The number of anterior gastric branches varied among specimens. A principal posterior nerve of the lesser curvature was present in 4.5 % of cases, and a single celiac branch was observed in all specimens. The first branch of the posterior trunk (criminal nerve of Grassi) was identified in 9 % of specimens. The number of posterior gastric branches ranged from three to eight, and the distance between the esophageal hiatus and the first gastric branch showed considerable variability. No statistically significant differences in vagal branching patterns were observed between individuals or between sexes. The abdominal vagus nerve demonstrates considerable variability in its distribution and branching pattern. Recognition of these variations is important during intraabdominal surgical procedures to minimize inadvertent vagal injury.