Clinical importance of a star shaped branch of internal iliac artery and unusual branches of an abnormal obturator artery: rare vascular variations.

Swamy Ravindra Shantakumar,Prasad Alathadi Maloor,Anitha Guru,Deepthinath Reghunathan,Abhinitha Padavinangadi,Satheesha Badagabettu Nayak

doi:10.1590/1677-5449.000116

Swamy Ravindra Shantakumar, Prasad Alathadi Maloor + Show 4 more

Open Access

https://doi.org/10.1590/1677-5449.000116

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Abstract

The internal iliac artery (IIA) is one of the branches of the common iliac artery and supplies the pelvic viscera, the musculoskeletal part of the pelvis, the gluteal region, the medial thigh region and the perineum. During routine cadaveric dissection of a male cadaver for undergraduate Medical students, we observed variation in the course and branching pattern of the left IIA. The artery gave rise to two common trunks and then to the middle rectal artery, inferior vesicle artery and superior vesicle artery. The first, slightly larger, common trunk gave rise to an unnamed artery, the lateral sacral artery and the superior gluteal artery. The second, smaller, common trunk entered the gluteal region through the greater sciatic foramen, below the piriformis muscle and presented a stellate branching pattern deep to the gluteus maximus muscle. Two of the arteries forming the stellate pattern were the internal pudendal artery and the inferior gluteal artery. The other two were muscular branches.

Highlights

The internal iliac artery (IIA) is one of the two terminal branches of the common iliac artery
The anterior division gives off the obliterated umbilical artery, superior vesicle artery, middle rectal artery, obturator artery, uterine artery, vaginal artery, inferior gluteal artery and the internal pudendal artery
We report here a rare assemblage of variations involving the IIA and its branches

Summary

INTRODUCTION

The internal iliac artery (IIA) is one of the two terminal branches of the common iliac artery. The arterial trunk passes subperitoneally downwards in front of the sacroiliac joint and, on approaching the upper margin of the greater sciatic foramen, it divides into anterior and posterior divisions. The anterior division gives off the obliterated umbilical artery, superior vesicle artery, middle rectal artery, obturator artery, uterine artery, vaginal artery, inferior gluteal artery and the internal pudendal artery. Knowledge of the variations in the origin, course and branches of IIA helps in planning and conducting surgeries involving the areas supplied by the artery. The obturator artery arose from inferior epigastric artery (IEA). It gave off two unusual branches before entering the obturator foramen. These two branches anastomosed with each other on the obturator internus.

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