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.

Variability of Origin of Obturator Artery and its Clinical Significance.

Background: Obturator artery is a branch of anterior division of internal iliac artery. It normally runs anteroinferiorly on the lateral wall of pelvis to the upper part of the obturator foramen and leaves the pelvis by passing through the obturator canal. On its course, the artery is accompanied by the obturator nerve and vein. It supplies the muscles of the medial compartment of the thigh. A severe and potentially lethal complication in pelvic injuries is arterial bleeding commonly involving the branches of the internal iliac artery, namely the lateral sacral, iliolumbar, obturator, vesical and inferior gluteal arteries. A sound knowledge of retro-pubic pelvic vascular anatomy is pivotal for successful performance of endoscopic procedures such as total extraperitoneal inguinal hernioplasty or laparoscopic herniorraphy. The context and purpose of the study: This study is an attempt to analyse the origin, course, distribution of obturator artery in pelvis and their clinical implication. Result: out of 60 formalin fixed pelvic halves 36.6% of the specimens, (26.67% in males and 10% in females) the origin of obturator artery was found to be normal from anterior division of internal iliac artery. About 63.63% from various other sources. Conclusion: This knowledge of variation in the origin of obturator artery is important while doing pelvic and groin surgeries requiring appropriate ligation. Such aberrant origins may be a significant source for persistent bleeding in the setting of acute trauma. Knowledge regarding the variations of obturator artery is useful during surgeries of fracture and direct or indirect inguinal, femoral and obturator hernias.

The applied anatomy of iliac tissue flap pedicled on the iliolumbar artery / 中华显微外科杂志

Objective To provide anatomical basis for elevating iliac tissue flap pedicled on the iliolumbar artery.Methods The course,number,outer diameter and distribution of iliolumbar artery were observed on 13 human cadavers.Results All the iliolumbar artery originated from the internal iliac artery.The iliolumbar artery gave off 2 branches (iliacus branch and lumbar branch) when passing between the obturator nerve and the lumbosacral trunk,posteriorly to the psoas major.The mean distance between origin of the iliolumbar artery and bifurcation point to iliacus and lumbar branches was 7.1 (7.1 ± 0.5) cm.The iliacus branch divided into two branches:one artery curved forward and anastomosed with the iliacus branch of deep circumflex iliac artery; the other artery supplied the tissue around the posterior superior iliac spine.The lumbar branch supplied the psoas major and the quadratus lumborum.Conclusion The iliolumbar artery and the iliacus branch is one of the most constant and reliable vessels supplying the iliac bone,and can be used as the pedicle of free or pedicled iliac tissue flaps.

Iliolumbar artery in Thais.

In a dissection of 335 pelvic halves of Thai adult cadavers, the iliolumbar arteries were classified into nine types according to the common or separate orgins of their branches. The percentage of type 1 to 9 are 38.8, 17.3, 36.1, 5.1, 0.3, 0.9, 0.6, 0.6 and 0.3, respectively.