Tromboflebitis séptica pelviana post cesárea / Septic pelvic thromboflebitis after cesarean section

RESUMEN Presentamos caso clínico de puérpera de cesárea de noveno día con cuadro febril en espigas, asintomática, en que se plantea desde su ingreso el diagnóstico de tromboflebitis séptica pelviana y se inicia tratamiento con antibióticos parenterales de amplio espectro y heparina de bajo peso molecular en dosis terapéuticas. La respuesta es a la mejoría al tercer día de tratamiento. Se discuten los métodos diagnósticos, el diagnóstico diferencial y el tratamiento.

ABSTRACT A case of a woman on her 9th post-operative day after childbirth by cesarean section (CS) consulting with febrile spikes, otherwise asymptomatic, is presented. The diagnosis of a septic pelvic thrombophlebitis is proposed from the admission and treated with parenteral broad-spectrum antibiotics and low-molecular-weight heparin at therapeutic doses. Patient significantly improved on her third day of treatment. The diagnostic procedures, differential diagnosis and treatment are discussed.

Pelvic congestion syndrome - treatment with pelvic varicose veins embolization

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.

Dolor pélvico crónico secundario a síndrome de congestión pélvica: resultados del tratamiento endovascular de la insuficiencia venosa pelviana y várices genitales / Embolization of insufficient pelvic veins for pelvic congestion syndrome: analysis of 17 cases

Background: Pelvic venous insufficiency may cause pelvic congestion syndrome that is characterized by chronic pelvic pain exacerbated by prolonged standing, sexual activity or menstrual cycle. It may be treated by embolizing the dysfunctional pelvic venous drainage and sometimes resecting vulvar, perineal and thigh varices. Aim: To assess the results of embolization of insufficient pelvic or ovarian veins on pelvic congestion syndrome. Material and Methods: Analysis of 17 female patients aged 32 to 53 years, who underwent subjected to a selective coil embolization of insufficient pelvic and/or ovarian veins through the jugular, basilic or cephalic veins. In the preoperative period, all patients had a lower extremity venous duplex pelvic ultrasound examination and some had an abdominal and pelvic CT angiogram. Results: The technical success of the procedure was 100% and no complications were registered. During a 32 month follow up, no patient had symptoms of pelvic venous insufficiency or relapse of vulvar or thigh varices. Conclusions: Embolization of insufficient pelvic and ovarian veins is a safe and successful procedure for the treatment of pelvic venous insufficiency or vulvar varices.

Descripción anatómica de la miología del miembro pélvico y su relación topográfica con el sistema vascular y nervioso en un ejemplar de pudú ( Pudu puda ) / Anatomical description of pelvic limb myology and its topographic relationship with vascular and nervous systems in pudú ( Pudu puda )

RESUMEN: El pudú (Pudu puda) pertenece a la familia Cervidae y se estima que su población actual total es menor a 10.000 ejemplares, razón por la cual se encuentra en la categoría de "Casi Amenazado" y dentro de la lista roja de la Unión Internacional para la Conservación de la Naturaleza (IUCN). La causa de la reducción de su población, es la pérdida y la fragmentación de los bosques del sur de Chile, caza, depredación, atropellos, entre otros. En las últimas situaciones mencionadas, es frecuente observar lesiones en la zona corporal caudal y miembros pélvicos del animal. Debido a lo anterior, se considera importante generar estudios morfológicos en el pudú que puedan ser un aporte en el conocimiento de ésta especie en particular. El presente trabajo corresponde a un estudio descriptivo anatómico del miembro pélvico de un ejemplar de pudú hembra. Se describió la musculatura y sus principales relaciones con vasos sanguíneos y nervios desde proximal hacia distal, dividiendo al miembro pélvico en cuatro regiones topográficas: cintura pélvica, femoral, crural y del pie. Además, se realizó de forma complementaria un estudio morfométrico de cada región topográfica y cada músculo que la compone. Los resultados fueron comparados con rumiantes domésticos, en relación a lo descrito en la bibliografía anatómica clásica, observando que el ejemplar analizado posee características anatómicas similares a lo descrito para pequeños rumiantes, sin embargo, existen diferencias importantes de tomar en consideración, tales como: el m. de la fascia lata presenta dos porciones sobrepuestas; el m. sóleo presenta un mayor desarrollo; el paquete vasculo nervioso femoral se observa atravesando la porción craneal del m. sartorio y el m. gracilis forma parte del tendón calcáneo común. La información entregada en este estudio corresponde a un aporte anatómico que permite ampliar el conocimiento científico de ésta especie poco estudiada, protegida y vulnerable.

SUMMARY: The Pudu (Pudu puda) belongs to the family Cervidae and it is estimated that its total current population is less than 10,000 specimen, which is why it is part of the "Near Threatened" category and on the red list of the International Union for Conservation of Nature (IUCN). The cause of the reduction of its population is the loss and the fragmentation of the forests of the south of Chile, hunting, predation, crashes, among others. In the latter situations, it is common to observe injuries in the caudal area and pelvic limbs of the animal. Due to the above, it is considered important to generate morphological studies in the Pudú that can be a contribution in the knowledge of this particular species. The present study corresponds to an anatomical descriptive study of the pelvic limb of a female Pudú. Musculature and its main relationships with blood vessels and nerves were described from proximal to distal, dividing the pelvic limb into four topographic regions: pelvic waist, femoral, crural and foot. In addition, a morphometric study of each topographic region and each muscle was performed as complementary analysis. The results were compared to domestic ruminants, in relation to those described in the classic anatomical bibliography, observing that the analyzed specimen has anatomical characteristics similar to that described for small ruminants, however, several important differences were observed and should be taken into consideration: the M. tensor fascia latae presents two overlapping portions; the M. soleus is more developed; the vasculature of the femoral nerve is observed through the cranial portion of the M. sartorius and M. gracilis is part of the common calcaneus tendon. The information provided in this study corresponds to an anatomical contribution that allows furthering scientific knowledge of this protected and vulnerable species.

Evaluation of embolization for periuterine varices involving chronic pelvic pain secondary to pelvic congestion syndrome

OBJECTIVES: To evaluate the clinical response and success rate after periuterine varices embolization in patients with chronic pelvic pain secondary to pelvic congestion syndrome and to report the safety of endovascular treatment and its rate of complications. METHODS: Retrospective cohort of patients undergoing endovascular treatment of pelvic congestion syndrome in our department from January 2012 to November 2015. Data were analyzed based on patient background, imaging findings, embolized veins, rate of complications, and clinical response as indicated by the visual analog pain scale. RESULTS: We performed periuterine varices embolization in 22 patients during the study, four of which required a second embolization. Seventeen patients reported a reduction in pelvic pain after the first embolization and three patients reported a reduction in pelvic pain after the second embolization. Minor complications were observed in our patients, such as postural hypotension, postoperative pain, and venous perforation during the procedure, without clinical repercussion. CONCLUSION: Periuterine varices embolization in patients with chronic pelvic pain secondary to pelvic congestion syndrome appears to be an effective and safe technique.

Symmetric bilateral aberrant obturator artery: a case report / Arteria obturatriz aberrante simétrica bilateral: reporte de un caso

Aberrant obturator artery (AOA) is an anatomical variation in the origin and course of the obturator artery, which is clinically important because of their vulnerability during surgical procedures performed in the pelvis. This article describes the case of a symmetrical AOA found in both hemipelvises of a male cadaver. Morphological and morphometric characteristics are presented, while their clinical significance is discussed.

La arteria obturatriz aberrante (AOA) es una variación anatómica del origen y trayecto de la arteria obturatriz que tiene importancia clínica debido a su vulnerabilidad durante los procedimientos quirúrgicos realizados en la pelvis. En este artículo se describe el caso de una AOA simétrica encontrada en ambas hemipelvis de un cadáver masculino. Se presentan sus características morfológicas y morfométricas, y se discute su importancia clínica.

Corona mortis: importancia anatomo ­ clínica y ocurrencia en una muestra de la población colombiana / Corona mortis: anatomical and clinical relevance and occurrence in a sample of the Colombian population

Corona mortis es una variación anatómica referida a la anastomosis de los vasos iliacos externos e internos, mediante vasos que se arquean por encima y por detrás del ramo superior del pubis. En caso de resultar lesionados iatrogénicamente, se pueden presentar hemorragias de difícil manejo. El objetivo del estudio fue caracterizar los vasos obturatrices en una muestra cadavérica de la población colombiana, para determinar su morfometría y la frecuencia con que se presentan los diferentes patrones venosos y arteriales. Se estudiaron hemipelvis de 14 cadáveres, pertenecientes al anfiteatro del Departamento de Morfología de la Universidad del Valle en Cali, Colombia. Tras acceder a la cavidad pélvica y completar la disección de todos los vasos que se relacionaban con el canal obturador y la cara pélvica del ramo superior del pubis, se determinaron sus características morfológicas y sus dimensiones. Las variaciones arteriales, corona mortis y arteria obturatriz aberrante, se presentaron en el 35,7% de las hemipelvis y las variaciones venosas en el 82,1%. La arteria corona mortis sólo se presentó en el 3,6% de las hemipelvis y el 32,1% presentaron arteria obturatriz aberrante. La moda de las frecuencias absolutas de los patrones venosos fue la vena corona mortis que se presentó en el 75,0% de las hemipelvis. El conocimiento de los patrones arteriales y venosos de los vasos obturatrices y de sus variaciones anatómicas para la población colombiana es indispensable para evitar lesionarlos durante procedimientos clínico - quirúrgicos que comprometan el anillo pélvico anterior y la región inguinal.

The corona mortis is an anatomical variation related to the anastomosis between the internal and external iliac blood vessels, through certain arteries and veins that form arches above and behind the superior pubic ramous. Serious hemorrhages can result from iatrogenic injury of these vessels. The study objective was to characterize the obturator vessels in a sample of Colombian cadavers, to determine their morphometric features and the frequencies in which the arterial and venous patterns are present. Hemipelvises of 14 cadavers from the dissection room of the Department of Morphology at the Universidad del Valle, in Cali, Colombia, were taken as sample. Once the dissection of the vessels related with the obturator canal and the pelvic surface of the superior pubic ramous was completed, their morphological features were determined and measurements were taken of their diameters and lengths. The arterial variations, corona mortis and aberrant obturator artery, were present in 35.7% of the hemipelvises and the venous variations in 82.1%. The corona mortis artery was only present in 3.6% of the hemipelvises and 32.1% presented an aberrant obturator artery. The mode of the absolute frequencies of the venous patterns was the corona mortis vein, present in 75.0% of the hemipelvises. The knowledge of the arterial and venous patterns of the obturator vessels and their anatomical variations for the Colombian population is very important in order to avoid causing any injury to them in the course of clinical and surgical procedures that have to do with the anterior pelvic ring and the inguinal region.

Congenital pelvic arteriovenous malformation presenting with urinary retention: a case report

To report a case of congenital pelvic arteriovenous malformation [pAVM] with urinary retention. A 39-year-old male patient presented with inability to void urine for 8 h. He did not have a history of dysuria or fever, but had increasing urinary frequency and difficulty in voiding over 2 years. Examination revealed a suprapubic mass without external signs of vascular anomaly. A huge, soft, irregular, non-pulsating mass was felt rectally. This mass did not disappear on urinary bladder decompression. Subsequent ultrasound and CT scan revealed pAVMs filling most of the pelvic cavity. To our knowledge, this is the first report of a male patient with congenital pAVM presenting with urinary retention, emphasizing the need for a high index of suspicion for pAVM to avoid potential severe bleeding during suprapubic catheterization for urinary drainage

Uso de endoprótesis bifurcada ilíaca para revascularización hipogástrica durante tratamiento de aneurisma aorto-ilíaco / Bifurcated iliac endograft in a patient with aortic-iliac aneurysm

A difficult anatomy is the major challenge to overcome with abdominal aortic aneurysm endografting. Bilateral iliac aneurysm preventing an appropriate distal landing zone for an endograft is a common condition and can be managed by: a) Increasing the diameter of the endograft, with limitations in available sizes; b) bilateral hypogastric embolization, accepting an increased morbidity; c) combining a surgical hypogastric revascularization by retroperitonel approach or d) retrograde revascularization from the ipsilateral external iliac artery using an endograft. Recently, branched endografts have been designed to revascularize the hypo gastric artery. Their deployment is complex but allows antegrade and stable flow. We report a 57 year-old male, at high risk for an open procedure, who presented with a small aortic aneurysm, bilateral iliac and left hypogastric aneurysms. A right bifurcated iliac endograft was deployed, associated with left hypogastric aneurysm embolization and aortic endografting. The patient recovered event free, patency of the endograft and absence of endoleak was demonstrated on a CT scan. He presented minor left buttock claudication, sexual function was preserved. This new technique allows safe endovascular treatment of patients with bilateral iliac aneurysm, allowing preservation of pelvic perfusion and avoiding the risk of an open procedure in a high risk patient.

Una anatomía desfavorable es un obstáculo a vencer con el tratamiento endovascular del aneurisma aorto-ilíaco. La presencia de aneurisma ilíaco bilateral es frecuente y amenaza la adecuada fijación distal de una endoprótesis. Esta condición puede ser manejada: a) aumentando el diámetro del dispositivo a nivel ilíaco, con limitaciones en las medidas disponibles; b) embolización hipogástrica bilateral, aceptando una morbimortalidad mayor; c) combinando un abordaje quirúrgico retroperitoneal para revascularizar una arteria hipogástrica, aumentando el impacto del procedimiento; d) mediante revascularización retrógrada unilateral desde la arteria ilíaca externa ipsilateral con otra endoprótesis. Recientemente se ha descrito el uso de endoprótesis ramificadas, que requieren un despliegue complejo, pero permiten revascularizar una o ambas arterias hipogástricas en forma anterógrada y estable. Reportamos el caso de un paciente de sexo masculino y 57 años, de alto riesgo para cirugía convencional, portador de un aneurisma pequeño de aorta abdominal y aneurismas ilíaco común bilateral e hipogástrico izquierdo. Fue tratado mediante despliegue de una endoprótesis bifurcada ilíaca, revascularizando la arteria hipogástrica derecha y embolizando la izquierda aneurismática, asociado a implante de una endoprótesis aórtica convencional, también bifurcada. El paciente evoluciona sin complicaciones, con claudicación glútea izquierda leve en disminución y preservación de su función sexual. Una tomografía axial computada demuestra exclusión efectiva de sus aneurismas. Esta nueva técnica permite tratar de manera segura a pacientes portadores de aneurisma ilíaco bilateral en forma endo-vascular, manteniendo perfusión de la circulación pelviana y disminuyendo el impacto de un procedimiento convencional en pacientes de alto riesgo.

Variability in the origin of the obturator artery

INTRODUCTION: General surgeons dealing with laparoscopic herniorrhaphy should be aware of the aberrant obturator artery that crosses the superior pubic ramus and is susceptible to injuries during dissection of the Bogros space and mesh stapling onto Cooper's ligament. The obturator artery is usually described as a branch of the anterior division of the internal iliac artery, although variations have been reported. MATERIALS AND METHODS: The present study was conducted on 98 pelvic halves of embalmed cadavers, and the origin and course of the obturator artery were traced and noted. RESULTS: In 79 percent of the specimens, the obturator artery was a branch of the internal iliac artery. It branched off at different levels either from the anterior division or posterior division, individually or with other named branches. In 19 percent of the cases, the obturator artery branched off from the external iliac artery as a separate branch or with the inferior epigastric artery. However, in the remaining 2 percent of the specimens, both the internal and the external iliac arteries branched to form an anastomotic structure within the pelvic cavity. CONCLUSION: The data obtained in this study show that it is more common to find an abnormal obturator artery than was reported previously, and this observation has implications for pelvic surgeons and is of academic interest to anatomists. Surgeons dealing with direct, indirect, femoral, or obturator hernias need to be aware of these variations and their close proximity to the femoral ring.

Utilización de la resonancia magnética con contraste de fase para el diagnóstico del síndrome de congestión pelviana / Using phase contrast MRA for the diagnosis of pelvic congestion syndrome

Introduction: Pelvic congestion syndrome (PCS) is produced by anomalous flow in ovarían veins. Direct venography (DV) is the gold-standard for diagnosis. Phase-Contrast Magnetic Resonance Angiography (PC-MRA) appears as an alternative that would permit a morphological and functional assessment. The purpose of the study was to evaluate the usefulness of flow velocity (measured with PC-MRA) as a diagnostic criterion and also to compare it with the DV technique. Patients and methods: We prospectively included 8 female patients with clinical suspicion of PCS who were referred for undergoing DV over a six-month period. PC-MRA examinations were performed in all of them. Slow anterograde or retrograde flow were the diagnostic criteria. Sensitivity, specificity, PPV, and NPV were also calculated. Results: Data from 16 veins were analized by means of a home-made software written in Matlab. There were 12 abnormal and 4 normal veins according to DV results. All the abnormal veins were correctly identified by MR-PC. Two veins (corresponding to the same patient) were considered as normal in accordance with DV results, whereas the PC-MRA analysis revealed them as abnormal veins. This patient presented with PCS typical symptoms. Sensitivity and specificity values were 100 and 50 percent, respectively, whereas PPV and NPV values were 86 and 100 percent, respectively. Conclusion: PC-MRA is a useful diagnostic tool for patients with clinical suspicion of PCS and could avoid unnecessary invasive procedures.

Introducción: El síndrome de congestión pelviana (SCP) es producido por flujo anómalo en las venas ováricas. La venografía directa (VD) es el estándar de referencia. La resonancia magnética con contraste de fase (MR-CF) permitiría una evaluación morfológica y funcional. El propósito fue evaluar la utilidad de la velocidad de flujo medida con RM-CF como criterio diagnóstico comparado con VD. Pacientes y Métodos: Incluimos prospectivamente 8 pacientes derivadas para VD por sospecha de SCP durante 6 meses; todas fueron sometidas a RM-CF. Los criterios diagnósticos fueron: flujo retrógrado o anterógrado lento. Se calculó sensibilidad, especificidad, VPP y VPN. Resultados: Analizamos los datos de 16 venas, utilizando un software propietario escrito en Matlab. Hubo 12 venas anormales y 4 venas normales en VD. Todas la venas anormales fueron correctamente identificadas por MR-PC. Dos venas (la misma paciente) fueron normales en VD y anormales en MR-PC. Esta paciente tenía clásicos síntomas de SCP La sensibilidad fue de 100 por ciento, especifidad de 50 por ciento, VPP de 86 por ciento y VPN de 100 por ciento Discusión: MR-PC es una herramienta útil en el diagnóstico del SCP y evitaría exámenes invasivos innecesarios.

Ethanol Embolotherapy of Pelvic Arteriovenous Malformations: an Initial Experience

OBJECTIVE: We retrospectively assessed the results of performing ethanol embolization for pelvis arteriovenous malformations (AVMs). MATERIALS AND METHODS: During the past 10 years, eight patients (8 females, age range: 27-52 years) with AVMs in the pelvic wall (n = 3) and uterus (n = 5) underwent staged ethanol embolizations (range: 1-5, mean: 2.5) under general anesthesia. Ethanol embolization was performed by the use of the transcatheter and/or direct puncture techniques. Clinical follow-up was performed for all of the patients, and imaging follow-up was available for seven patients. The therapeutic outcomes were established by evaluating the clinical outcome of the signs and symptoms, as well as the degree of devascularization observed on post-procedural angiography. RESULTS: During the 20 sessions of ethanol embolization, the solitary transarterial approach was used 14 times, the transvenous approach was used three times and direct puncture was used once. For two patients, the transarterial and transvenous or direct puncture approaches were used together in one session. For four patients, ethanol and coils were used as embolic agents, and n-butyl cyanoacrylate (NBCA) and ethanol were used in one patient. Seven (88%) of eight patients were cured of their AVMs and one patient (12%) displayed improvement. Major complications were seen in two patients (25%). CONCLUSION: Ethanol embolization is effective for the treatment of pelvic arteriovenous malformations, though there is a chance of a major complication.

Histological and biochemical serum effects of alpha-tocopherol on ischemia/reperfusion-related injuries induced in the pelvic limb of rats

OBJETIVO: Avaliar ação protetora do alfa-tocoferol na lesão de isquemia e reperfusão em membro pélvico de ratos. MÉTODOS: Trinta ratos machos adultos da linhagem wistar foram distribuídos aleatoriamente, em três grupos experimentais, com 10 animais cada: Grupo I – Grupo controle sem isquemia ou reperfusão. Grupos II e III – quatro horas de isquemia e duas horas de reperfusão através clampeamento da aorta infra-renal. Os animais do grupo II foram tratados com solução salina e aqueles do grupo III, tratados com alfa-tocoferol 50 mg/kg por via endovenosa. Parâmetros estudados: Biópsias do músculo solear, dosagens da creatina fosfoquinase, da desidrogenasse láctica, do potássio, do cálcio e da hemogasometria arterial. RESULTADOS: Os resultados das biópsias dos músculos soleares estudados através da microscopia óptica, não foram significantes quanto a presença de edema entre os três grupos estudados. As variáveis inflamação e necrose não foram observadas e, portanto não analisáveis estatisticamente. Em relação às dosagens de cálcio e desidrogenase lática, pH, pO2, pCO2, não foram significantes em todos os grupos estudados. Observamos que os níveis de potássio (Grupo II > grupo I, F calculado = 5,84; F crítico = 3,33), creatina fosfoquinase (Grupo II > Grupo I e III, H calculado =13,92; Hcritico 5,99) , e bicarbonato (grupo I e III > grupo II, H calculado = 11,98; h critico 5.99 ) apresentaram resultados significantes entre os grupos. CONCLUSÃO: Tratamento com alfa-tocoferol do ponto de vista bioquímico sérico atenuou as lesões metabólicas na síndrome de isquemia e reperfusão neste modelo experimental.

case report and review of the literature: Pelvic congestion syndrome

Pelvic congestion syndrome [PCS] is a well described, but frequently overlooked cause of chronic pelvic pain. It is manifested by pelvic pain of variable intensity that is aggravated by prolonged standing, fatigue, menstruation or intercourse.Although the condition has been described since the middle of the nineteenth century, the exact cause of the condition is not fully understood. Recent advances in imaging and laparoscopy have helped in achieving an accurate diagnosis. Surgical procedures are not always helpful in managing cases of pelvic varices. The most recent breakthrough has been the management of gonadal varicosities by an embolization technique. This case was first suspected following a pelvic ultrasound study. The diagnosis was confirmed by venography and embolization was performed in the Radiology Depar tment. This treatment modality is the first ever in the Kingdom of Bahrain. It shows specialized skills can satisfactorily cure a hither to difficult disease with simple minimally invasive techniques

Chronic Post-thrombotic Obstruction of the Inferior Vena Cava: Both Renal Veins being the Cause of Painless Gross Hematuria from Pelviureteral Mucosal Varices in Normal Functioning Kidney

A 31-year-old man presented with painless gross hematuria. His serum-creatinine level was within the normal range. Abdominopelvic CT showed an infrahepatic calcified fibrous cord, which was suggestive of inferior vena cava (IVC) remnant. Extensive venous collateralization around both kidneys and venous drainage of the extremities via the inferior epigastric and internal thoracic veins were shown. We report a case of chronic post-thrombotic obstruction of the IVC, involving both renal veins, which was believed to be the cause of painless gross hematuria from mucosal varices of the pelviureteral system in normal functioning kidney.

Chronic Post-thrombotic Obstruction of the Inferior Vena Cava: Both Renal Veins being the Cause of Painless Gross Hematuria from Pelviureteral Mucosal Varices in Normal Functioning Kidney

A 31-year-old man presented with painless gross hematuria. His serum-creatinine level was within the normal range. Abdominopelvic CT showed an infrahepatic calcified fibrous cord, which was suggestive of inferior vena cava (IVC) remnant. Extensive venous collateralization around both kidneys and venous drainage of the extremities via the inferior epigastric and internal thoracic veins were shown. We report a case of chronic post-thrombotic obstruction of the IVC, involving both renal veins, which was believed to be the cause of painless gross hematuria from mucosal varices of the pelviureteral system in normal functioning kidney.

Ligadura das artérias hipogástricas em ginecologia e obstetrícia / Hypogastric arteries ligation in gynecology and obstetrics

O sangramento em tocoginecologia é o principal responsável por uma alta taxa de mortalidade materna e por um grande número de histerectomias. No presente trabalho, os autores faze uma revisäo sobre o uso da ligadura das artérias hipogástricas no controle dessas hemorragias; descrevem a técnica, alteraçöes hemodinâmicas e complicaçöes do procedimento

Elementos anatómicos del canal obturado / Anatomical elements of the obturated channel

Para conocer el comportamiento de los elementos anatómicos del canal obturado en la población chilena, se disecan 40 casos en los que se analiza la distribución de los elementos en el canal, las variaciones en cuanto al origen de las arterias obturadora interna y epigástrica inferior, las anastomosis entre ellas y el sitio de bifurcación del nervio obturador. Los resultados obtenidos se comparan con la literatura clásica y otras publicaciones