The Origin Variability Of The Iliolumbar Artery: A Cadaveric Study With Clinical Significance

Introduction: Hemorrhage represents has been considered as the leading cause of maternal death in developingcountries and one of the major causes of morbidity and mortality in obstetrics and gynecological surgery.Iliolumbar artery (ILA) is one of the branches of the posterior division of the internal iliac artery. The source ofILA has been documented from all possible neighboring arteries. So the course and ramification of the ILA havereceived attention for gynecologists and surgeons.Materials and methods: Study was conducted on 30 bisected pelvises specimens in Department of Anatomy,Gulbarga Institute of medical sciences, Gulbarga. The pattern of origin of the iliolumbar artery (ILA) was identified.The origin and course of ILA were evaluated.Results: In the present study, we observed the ILA was most commonly originated from the trunk of IIA in 36.67%,from posterior division of IIA in 23.33%, and from the common iliac artery in 13.33%. The incidence of absenceof ILA was recorded in 26.67% specimen.Conclusion: The surgeons, especially while doing pelvic surgeries or obstetrics and gynecology surgeries, shouldbe aware of the normal anatomy of the internal iliac artery and its variations for the successful ligation of theinternal iliac artery and for the safe surgical outcomes.

Hypogastric artery ligation to treat massive hemorrhage in pelvic fractures with abdominal organ injuries / 中华创伤骨科杂志

Objective To evaluate the effects of hypogastric artery ligation to treat massive hemorrhage in pelvic fractures with abdominal organ injuries. Methods The pelvic fractures of 16 patients were classified as Tile B type in 10 cases and C type in 6. Among them there were 6 open fractures and 20 sites of abdominal visceral injuries. The capacity of retroperitoneal hematoma, which was ruptured in 6 cases, ranged from 800 ～2 500ml with 1 400ml on average. The bleeding volume in the survivals was 1 500～5 800ml with 2 600ml on average. Ligation of bilateral hypogastric artery was carried out in all patients with intra abdominal injuries within 6h. Of them, skeletal traction was used in 7 cases while pelvic external fixation in 5 cases. Results One death occured dut to consumptive coagulopathy with hematorrhea. Of the 15 survivals, bleeding was controlled in 8 cases, decreased in 5 and uncontrolled in 2. The effective rate was 81.3%(13/16) and the survival rate 93.8%(15/16). Conclusion When emergency celiotomy is performed for abdominal injuries, a rational application of hypogastric artery ligation can play a positive role in control of pelvic hematorrhea.