Pathology. The Gore vascular graft line also includes the GORE-TEX ® Stretch Vascular Graft, with published improved patency for dialysis access (10 papers, 650 patients and one abstract). Gore vascular grafts are also available in a wide range of Stretch and non-stretch configurations, including straight, tapered, bifurcated, and many with external. Great posted photos. The porta hepatis, also known as the transverse hepatic fissure, is a deep fissure in the inferior surface of the liver through which all the neurovascular structures (except hepatic veins) and also hepatic ducts enter or leave the liver 1 . Intermuscular AVMs can require an incision in the gluteal fold that continues to the lateral buttock, permitting the gluteus maximus muscle’s. (a) ˙x versus x; (b) bifurcation diagram. The ureter begins its descent to the bladder by running along the medial aspect of the psoas muscle. The vertical line starts from sacrum to the perineum. The umbilical vein is the conduit for blood returning from the placenta to the fetus until it involutes soon after birth. Gross anatomy. Gluteal tendinopathy is a common cause of hip pain, especially in older women. Neural tube defects are a spectrum of disorders that can affect the brain or the spinal cord. Benign Hip ClickResults. A total of 34 (24%) patients had an abnormal spinal US; 15 (44%. 2: Saddlenode bifurcation. -Pelvic abscess extending intobuttock inpostoperative patient. A lump of the lower back. Asymmetrical gluteal folds may be present. I’ve noticed my baby has a Y shaped cleft on her bottom. Small amounts of pain that go away after a few days. The femoral-gluteal adipose tissue (AT) depot is postulated to play a role in the uptake of fatty acids from the circulation and to act as a reservoir for excess triglycerides storage in adipose cells . The gluteal region refers to the general region of the posterior buttocks, lying external to the pelvic cavity. Renal tract pathology (e. May 6, 2021 at 5:44 AM. If the address matches an existing account you will receive an email with instructions to retrieve your usernamespina bifida (bifurcated gluteal fold) spina bifida (hypertrichosis) holoprosencephaly (alobar) holoprosencephaly (semilobar) holoprosencephaly (cyclopia) holoprosencephaly (ethmocephaly) olfactory aplasia. Our content is doctor approved and evidence based, and our community is moderated, lively, and welcoming. This is a difficult area to fix. The lower part of posterior compartment of thigh was the most common (47. The gluteal fold flap was designed as a transposition or VY-advancement flap. Thigh folds that are asymmetrical rarely indicate hip dysplasia unless they are associated with uneven gluteal creases. 4 to 3. The. DOI: 10. Over the tuberosity of the ischium or infra-gluteal fold (S3) Reflexes [edit | edit source] Knee jerk (L3 and 4) Ankle jerk (S1) Neurodynamic [edit | edit source] Neurodynamic tests can be used to assess the mobility of the nervous system. ICD-10-CM Diagnosis Code M76. Figure 4: degrees of ptosis (A) Degree zero: the crease can reach T-line but not overpass it. 2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. E. 10 Dissection proceeds proximally through the levator complex. CONCLUSION. k. 0 mm for the vein according to various authors [ 7, 13, 14 ]. The gluteal fold flaps are based on the dense network of perforators of the internal pudendal artery near the midline of the perineum between the anus and the ischial tuberosity (Figure 2). The technique is simple and reliable. location: pelvis, anterior to the sacroiliac joint. Given that understanding the anatomy of the superficial fascial system (SFS) may facilitate the improvement of liposuction techniques, this study aimed to clarify and define the anatomic components of the GF. border of the sciatic nerve to the back of the thigh. 2 cm). 061 became effective on October 1, 2023. gluteal fold: [ fōld ] plica; a thin margin curved back on itself, or doubling. Superior: iliac crest. Mild instability (defined below) is also considered an equivocal finding. infection, calculus) can affect pelvic kidneys and thus the referred pain is not typical for the renal tract and it may be confused for other abdominopelvic pathology, e. 3). aryepiglottic fold a fold of mucous membrane extending on each side between the lateral border of the epiglottis and the summit of the arytenoid cartilage. Inferior : gluteal folds. These are end arteries and. 2016. Gross anatomy Origin. Sacral dimples are very common—they’re present in 2-4% of newborns overall! Almost all neurosurgical referrals for suspected OSD in children <1yo are for evaluation of a dimple. (Case 1) had a hemangioma and deviated gluteal folds, and he also had FTF. Significance of inguinal folds for diagnosis of congenital dislocation of the hip in infants. The posterior vaginal wall is divided 2 cm above the tumor. However, their length may vary from 2–3 cm up to 8–10 cm. 6 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Dissection of gluteal region and posterior compartment of the thigh was done to expose the sciatic nerve. It goes laterally up to a virtual line converging the anterior superior iliac spine to the anterior edge of higher trochanter and Medially goes up to mid-dorsal line and natal cleft. The superior gluteal nerve is found in the lower pelvis and arises from the dorsal divisions of the L4, L5, and S1 nerve roots of the sacral plexus. Innervates muscles of the posterior compartment of the thigh ( tibial component) and all muscles below the knee, via its tibial and common fibular components. 0):. The surgeon will be able to determine if you just need a gluteal fold or if you benefit from additional volume. The patient has an unusual sacral crease and sacral dimple. 2011 Mar;32 (3):109-13. While the diagnosis of acquired GF relies primarily on clinical findings, poliomyelitis and other diseases, cerebral palsy, and neuromuscular disorders. In one series of 187 children referred with asymmetric thigh creases alone (in the absence of any other signs) only one child required intervention. Define gluteal fold. Gluteal cleft is the vertical partition which separates buttocks. Patients with FTF (3 [21. The gluteal cleft most of the time heals on its own but if not, then a proper treatment along with a pain reliever is recommended. Results: The most common lumbosacral cutaneous manifestations were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). It’s a visible crease where the buttocks naturally fold over and create a physical line in the skin. 072 may differ. The aorta is the first and largest artery in the body. The vessel can be divided into various. Motor function is generally more affected than sensory function and is correlated with the level of spinal aplasia. Fat Removal. A gluteal fold can most definitely be created. B. The indications for anorectal excision were rectal. The sacral plexus is formed by the union of the ventral branches of L5 and of the first three spinal sacral nerves (S1 to S3) (Figs. 1 Similarly in 2016, the United States saw a 26% increase, more than 18,000 operations,. B, D, F, Postoperative views after treatment with subfascial placement of silicone elastomer implants, which increased projection, shortened the infragluteal fold, and restored volume to. External iliac vein. My boyfriend has an ulcer (looks like a bedsore) along one side of his gluteal fold. We would like to show you a description here but the site won’t allow us. Although intertrigo can affect only one skin fold, intertrigo commonly involves multiple sites. The right hepatic vein is a single dominant vein in ~70% (range 60-78%) of individuals. Y shaped gluteal cleft. A perineal branch passes medially to supply the skin of the scrotum or labia majora in the perineum. 850A. Access records and results, view and pay bills, request prescription renewals, and request appointments. A technique for reconstruction of the gluteal fold and preliminary results are presented. The umbilical vein arises from multiple tributaries within the placenta and enters the umbilical cord, along with the (usually) paired umbilical arteries. Herein, we report a case of porokeratosis ptychotropica. Pathologic entities in the gluteal region reflect the diversity of tissue types present. , a bulky skin fold along the upper edge of the gluteal sulcus), and route 3, just along the gluteal sulcus. 072 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Diagram summarizing the muscles location of the gluteal group. 1177/2333794X19851419 Corpus ID: 195071865; Importance of Physical Examination and Imaging in the Detection of Tethered Cord Syndrome @article{Shields2019ImportanceOP, title={Importance of Physical Examination and Imaging in the Detection of Tethered Cord Syndrome}, author={Lisa B. The mean operation time of Group A was approximately 3. Volume enhancement with soft tissue fillers of the gluteal region is emerging as a highly. Answer: Lower butt lift. The right hepatic vein is a single dominant vein in ~70% (range 60-78%) of individuals. The left CIA course is simpler, running parallel and lateral to the left common iliac vein. Conclusion: The use of a deepithelialized double dermal flap is a safe and new way to obtain excellent results in rejuvenation of the gluteal region. The term 'saddle-node bifurcation' is most often used in reference to continuous. Superior gluteal artery. 9. Herein, we report the clinical, dermoscopy, and reflectance confocal microscopy (RCM) aspects of a case of PP in a 63-year-old Caucasian woman along. a. It extends from sacral level S3 or S4 and ends just inferior to the apex of the sacrum, at the level of the anus. 5-fold increase (from 0. A gluteal fold in and of itself is the area where the buttocks are separated from the upper thigh. It is oozing serosanguinous fluid and i think it's about 5 to 6. When possible, 2 cm of skin is kept around the anus to suture. E. <2. Gluteal Fold: Cadaveric Dissection of the Superficial Fascial System in the Buttock and Anatomy-based Gluteal Liposculpture Plast Reconstr Surg. Treatment of a gluteal injury depends upon the type of the trauma. With the patient in the standing position, the gluteal fold was marked . Infant is a product of an uncomplicated pregnancy and delivery. Medially, the region extends to the mid-dorsal line and is called the intergluteal cleft, which is the groove that separates the buttocks from each other. In very mild cases, such as isolated. 45 This results in a ptotic butt if it is longer. There may be an early bifurcation, early trifurcation or even multiple right hepatic veins entering the IVC. Q35. 8 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Results: The most common LsCMs were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). 5 cm from the anus. It is a valveless vein, in most people 3, and therefore. A bifurcated AFX2 was placed in the infrarenal aorta; IBE was advanced to the origin of the right limb of the AFX2. The commonest anatomical variant of the hepatic veins. 3%) than those. diseases of the male reproductive organs. Results: The most common LsCMs were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). (B) In setting of the split gluteus maximus muscle flap and IGAP flap. The hip joint is this joint between the head of the femur and the acetabulum of the pelvic bone. Just prior to the porta hepatis it divides into the left and right hepatic arteries. Pectoral augmentation, gluteal augmentation, body lift and abdominoplasty, and. The infragluteal fold is one of the major concerns in reshaping of the gluteal region. The middle hepatic artery (MHA) is an intrahepatic hilar arterial branch, usually arising from the left hepatic artery, which supplies segments 4a and 4b. Multiple, sporadic, brownish papules, 1-5 mm in diameter in size, along the gluteal folds sparing the anus. OBJECTIVE. Interestingly, anomalies of the gluteal crease are the most commonly encountered findings in well neonates, with 1 study reporting an incidence of 24. A bifurcation occurs in a nonlinear differential equation when a small change in a parameter results in a qualitative change in the long-time solution. OBJECTIVE. Treatment is typically not necessary as it is a benign condition. Fourteen (21%) of the 67 patients had an abnormal spinal ultrasound; 5 of. The myocutaneous gracilis flap (MGF) and the gluteal fold flap (GFF) are common options for defect coverage in this area. cutaneous manifestations were duplicated or bifurcated (46%) gluteal folds and gluteal asymmetry (16%). Citation, DOI, disclosures and article data. The anterior trunk gives rise to numerous branches that supply the pelvic organs, the perineum, and the gluteal and adductor regions of the lower limb. The Gluteus medius and minimus work together as hip abductors and are vital to normal. Obturator artery –. Abstract. The superficial branch of the superior gluteal artery or the posterior branch of the fourth lumbar artery reliably supplies the bilobed flap. The internal iliac vein (IIV) represents the union of veins and venous plexuses draining the pelvic viscera, pelvic wall, external genitalia, perineum, buttocks, and medial thigh. The banana fold, or the infragluteal fold, is a fat deposit on the posterior thigh close to the gluteal crease and parallel to it. 02 [convert to ICD-9-CM] Gluteal tendinitis, left hip. Slightly above the ischial tuberosity is MTP2, the most common trigger point of this muscle. It surrounds, and helps fix to the duodenum, the duct of Wirsung, common bile duct and the ampulla of Vater 1,2 . The superior suprarenal arteries arise from the inferior phrenic artery. It is a tortuous artery, running superior to the pancreas before turning forward into the splenorenal ligament to the hilum of the spleen. Sign in to MyChart. The gluteal fold is the term used to describe the horizontal skin crease that forms below the buttocks, separating the upper thigh from the buttocks. The inferior limit of the flap is marked 1 cm inferior and parallel to the gluteal fold. Doctor of Osteopathic Medi. Gross anatomy. Cleft uvula. Therefore, the inferior gluteal vessels have excellent caliber proximally. The skin may look inflamed, smooth, or scaly, and may feel itchy and uncomfortable. Fourteen (21%) of the 67 patients had an abnormal spinal ultrasound; 5 of. It relates to pain in the entire buttock and. Keep the area clean, wash it gently with mild soap, and pat it dry. discrepancy, or asymmetric thigh/gluteal folds. 5%) Mongolian spot on back: 1 (2%) Sacral dimple: 3 (4. It is formed from the L5-S2 nerve roots and shortly after forming exits the pelvis through the greater sciatic foramen beneath the lower border of the piriformis muscle and along the posterior aspect of the sciatic nerve. agenesis of corpus callosum. Abducts and medially rotates femur at hip joint; during walking, keeps the pelvis stable over the stance leg, which prevents the pelvis. Conditions that Mimic Hip Dysplasia. 3 percent of respondents as the most attractive. The gallbladder is involved in the storage, concentration, and ejection of the bile. Code History. hairy tuft, rudimentary tail, hemangioma)Spina Bifida Occulta (Occult Spinal Dysraphism) Spina bifida occulta is a common anomaly consisting of a midline defect of the vertebral bodies without protrusion of the spinal cord or meninges. They are caused by interaction of genetic and environmental factors, and are prevented with folate supplementation. The L4 element joins the ventral branch of L5 to form the lumbosacral trunk. Fig. Superior gluteal artery. defined the infragluteal fold as a result of gluteal ptosis secondary to sagging of the buttocks and redundant gluteal tissue [ 9 ]. Other signs and symptoms of ectopic kidneys include: incontinence. origin and termination: union of internal and external iliac veins; into the inferior vena cava. interdigital fold the free border of the web connecting the bases of adjoining digits. This muscle inserts onto this band of fascia, the iliotibial tract. ” Mesh or see-through tops are not allowed. This may be achieved with liposuction alone, liposuction in combination with lipotransfer, gluteal lift, silicone implants, injectable alloplastic implants, or a. The external iliac vein (EIV) is located along the pelvic brim between the inguinal ligament and the sacroiliac joint. Fifteen (11%) patients had two LsCMs, while one (1%) patient presented with three LsCMs (Table 1). 86: Hydronephrosis: Lumbar. Duplicated gluteal creases were classified based on crease appearance above the buttocks. The quest for gluteal rejuvenation traces back over 50 years, with Pitanguy’s reports of improved gluteal aesthetics through resection of the trochanteric regions and the gluteal fold []. Gluteal muscles exercises should be performed 2-3 times a week. Methods The newly formed gluteal. The superior gluteal artery is the largest branch of the internal iliac artery and supplies the muscles and skin of the gluteal region. The other synonyms of gluteal cleft are anal. Bilateral gluteal tendinitis; Gluteal tendinitis of left hip; Left gluteal tendinitis; Tendinitis of bilateral gluteal tendons. Skin folds, including inframammary , intergluteal, axillary, and interdigital areas, may be involved. It approaches the greater sciatic foramen by passing back through the parietal pelvic fascia and between the S1 - S2, or S2 - S3 nerve roots. Those are the three gluteus muscles – gluteus maximus, medius and minimus. Several options are available, none however are without complications and side effects. ICD-9-CM 757. H. Diagnoses: Physical examination revealed multiple sinuses with broad surrounding scars in both inferomedial gluteal areas, which. z. The left renal vein is much longer, at 6-7 cm, than the right renal vein, at 3-4 cm, but they have a similar caliber (~1. It's usually just above the crease between the buttocks. It has two limbs: the lateral limb descends along the pelvic brim, over. However, it was not until the 1980s that surgeons turned to the relatively new technology of liposuction to restore volume and improve contour. Pelvic and perineal defect and flap design. Course. The caliber of the main SGV trunk prior to bifurcation averaged 5. Procurement of a workable pedicle length that. Although the concept of body beauty has changed over the years, the size and shape of the gluteal region remains a symbol of femininity. Gluteal crease Gluteal fold. 6 may differ. Signs and symptoms of gluteal injuries include swelling, bleeding, and inflammation. Most commonly applied to the mathematical study of dynamical. The musculature is formed principally by the three gluteal muscles: Maximus, medius, and minimus. Nevertheless, accurate classification of these lesions is. Follicular porokeratosis of Mibelli restricted to the genital region has been described. Idiopathic gout, left ankle and foot. The gluteal region, commonly known as the buttocks or glutes, is the posterior part of the pelvic area. 53%) and the upper part of. Challenges in classification of gluteal cleft and buttocks wounds: consensus session reports. The main artery in the gluteal region is the internal iliac artery, which gives off branches, namely the superior gluteal artery, inferior gluteal artery, and internal pudendal artery. From an aesthetic viewpoint the gluteal fold flap (Figs. The most frequent LsCM were bifurcated/duplicated gluteal folds, gluteal asymmetry, and a sacral dimple (Tables 1 and 3; Figure 1(a) and (b)). 39 should only be used for claims with a date of service on or before September 30, 2015. The size of each flap was 14 × 8 cm. Standardized rules and measurements have been attemptedAnswer: Gluteal fold can definitely be created. . For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code (or codes). Bifurcation means the splitting of a main body into two parts. Approximate Synonyms. Samir Shureih MD. The organ of Zuckerkandl comprises of a small mass of chromaffin cells derived from neural crest located along the aorta, beginning cranial to the superior. 072 - other international versions of ICD-10 M10. 7, ,8 8 showing respectively cases 11 and 24) was superior because of the well-concealed donor scar [11,12]. The distal portion of these flaps correspond to the location of the projected inferior gluteal folds. Keep your arms straight as you lift the weight with your hips and glutes. coverage using symmetrical keystone flaps (KFs) designed parallel to relaxed skin-tension lines (RSTLs). Internal iliac artery (IIA) is one of the terminal branches of the common iliac artery and is the prime artery of pelvis. 5 mm for the artery, and 2. Summary. c. 10 Albright,12 a neurosurgeon from Wisconsin, estimated a notably high A B. 7 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The right CIA passes anterior to the left common iliac vein and then anterior and parallel to the right common iliac vein. fold1 top: isocline fold center: overturned fold bottom: recumbent fold v. 5%) Two of the above-mentioned findings: 9 (13%) Mean age at spinal ultrasound: 7 weeks (1 day to 16 weeks) Spinal ultrasound findings Normal:A sacral dimple is an indentation or pit in the skin on the lower back that is present at birth in some babies. An ellipse is drawn for the skin paddle to include these perforators, which roughly parallels the gluteal fold with. It descends caudally in the retroperitoneum, anterior and slightly to the left of the lumbar vertebral bodies. Structure. Patients with FTF-associatedThe gluteal fold flap was reported as “lotus petal flap” by Yii and Niranjan. If too much fat it can be repaired by liposuction and fat transfer to the gluteal dimple. The unibody design avoids the need to cannulate the contralateral gate and allows for placement of the flow divider of the bifurcated component of the UBE system directly on the native aortic bifurcation. The common iliac arteries (CIAs) enter the pelvis on the medial aspect of the psoas muscle. The gluteal region communicates with the pelvic cavity. Lipoplasty aided in the accentuation of lumbar lordosis, which gives the impression of greater buttocks projection. Fourteen (21%) of the 67 patients had an abnormal spinal ultrasound; 5 of the 14 infants underwent a lumbar magnetic resonance imaging. Gluteal cleft Shield Gluteal cleft shield is a cover which is used to avoid problems related to gluteal cleft. Bifurcated gluteal fold: CM ends at L2-3: CM ends at L2-3: No clinical TCS; PT: Male/10. The IVC has a retroperitoneal course within the abdominal cavity. 1 Given the low incidence rate of OSD at 0. Evaluate the gluteal folds for asymmetry, and observe for any restrictions in movement. 7 The locations of the perforators from the internal pudendal artery. Sciatic Nerve (L4, L5, S1, S2, S3) Composed of the tibial and common fibular (peroneal) nerves. right elbow and left knee relieved with medication. More than 50% of OSDs are diagnosed when a dimple is noted, but obviously not all dimples are associated with an OSD. CT has long been used to characterize the composition and anatomic location of soft-tissue masses [3-5] and has been known for several decades to be able to. 8 may differ. There may be an early bifurcation, early trifurcation or even multiple right hepatic veins entering the IVC. amniotic fold the folded edge of the amnion where it rises over and finally encloses the embryo. The damaging effects of moisture, pressure, friction, and shear on human tissue are well. It enters the pelvis anteriorly to the sacroiliac joint at the bifurcation of the common iliac vessels (at the pelvic brim) and then courses. A 49-year-old female suffered from a fever and rectal ulcer after undergoing internal hemorrhoid. 49. Course. Fee $6,000+ Best to virtual consult with. The artery has many parietal and visceral branches and hence the variations are frequently noted. Variant anatomy. Contour deformity is the most common complication of liposuction, with an incidence of up to 20% (1–3). agenesis of corpus callosum. Time and important weight variation consid-erably affect this region combined with the gravity’s effect. 86: Circumcision: Lumbar Mongolian spot: CM ends at L2-3: CM ends at mid L2: No clinical TCS; PT: Male/0. It is characterized by two separate folds of skin located where the buttocks meet the thighs. Here, the ureter lies anteriorly and slightly medial to the tips of the L2-L5 transverse processes. Location. Our technique allows for the. Functionally it is part of the lower extremity. Signs & symptoms Signs and symptoms of a tethered cord can include the following: A crooked toe. There is a very specialized method to form infra gluteal crease, using lipo 360 with directed fat grafting under ultrasound guided injections as required in Florida, and specialized sub dermal lipo techniques with taping to form infra gluteal crease. It’s important not to mistake the transverse gluteal fold for the lower border of the gluteus maximus muscle. Home - EMEESYThe patient in case 2, a 62-year-old woman with recurrent cervical cancer, underwent total pelvic exenteration with extensive perineal resection and bilateral gluteal flap. ”. DX? If this is your first visit, be sure to check out the FAQ & read the forum rules. The internal iliac artery is ~4 cm long and gives rise to an anterior trunk (branching off to the obturator, internal pudendal, inferior gluteal, and. Pressure injuries, however, are ischemic injuries to the skin and underlying soft tissue that can result in full-thickness tissue damage. Although the safety of gluteal augmentation with autologous fat grafting is still controversial, the proportion of operations is increasing year by year. aryepiglottic fold a fold of mucous membrane extending on each side between the lateral border of the epiglottis and the summit of the arytenoid cartilage. [email protected] authors believe that asymmetric gluteal folds are an important finding suggesting hip dysplasia in infants and further studies such as ultrasound or simple radiographs are needed for further evaluation. A total of 34 (24%) patients had an abnormal spinal US; 15 (44%. The 2000 AAP clinical practice guideline gave a detailed description of the examination, including observing for limb length discrepancy, asymmetric thigh or gluteal folds, and limited or asymmetric abduction, as well as performing Barlow and Ortolani tests. Here, the ureter lies anteriorly and slightly medial to the tips of the L2-L5 transverse processes. Innervation. C. Gluteal cleft is the vertical partition which separates buttocks. The purpose of this study was to perform an anatomical description of. Use an absorbent diaper and wrap it. It is a visible border separating ass into two parts. Subtractive approaches of adjacent areas to the gluteal region can enhance the overall appearance of the buttocks. I think getting the ultrasound is a great idea because we do want to see if there is an issue with the lower part of the spinal cord. It is also called butt crack or ass crack. 7. tr. Asymmetric gluteal folds or adductor folds are seen in 30-71% of normal infants. Course and termination. 5 and 2. The gluteal fold flap was first described as a variation of the lotus petal flaps by Yii and Niranjan in 1996. A total of 34 (24%) patients had an abnormal spinal ultrasound; 15 (44%) of these infants underwent a lumbar magnetic resonance imaging. The most common lumbosacral cutaneous manifestations were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). The dorsal approach with tailored sacrectomy and gluteal V–Y advancement flap is a valuable option in highly selected patients to treat recurrent pelvic sepsis after multiple prior transabdominal interventions for chronic presacral sinus. 1 Its histological hallmark is the formation of cornoid lamellae, which is a column of firmly contoured parakeratotic cells in the upper epidermis. The most common cutaneous manifestations were duplicated or bifurcated (46%) gluteal folds and gluteal asymmetry (16%). Satisfactory results were obtained in both cases. circular f's the permanent. Above the greater sciatic notch as a confluence of the gluteal veins and the pelvic tributaries described below. Once it enters the fetus at the umbilicus, it courses upwards towards. The purpose of this study was to illustrate the spectrum of solitary gluteal lesions in children. circular f's. Medially, an intergluteal cleft separates the two buttocks from each other, while laterally they are bounded by the hip regions. (a) (b) Figure 11.