Unusual Path of Branches of Ilioinguinal Nerve: A Clinically Important Anatomic Variant

Ilioinguinal nerve is a collateral branch of lumbar plexus. Its anatomical variations in relation to adjacent musculoaponeurotic structures play a crucial role in the development of neuropathies associated with lower abdominal surgeries. In this report, we present a rare case of unusual course and branches of the ilioinguinal nerve, in a 55-year-old male cadaver. In the lateral part of inguinal canal ilioinguinal nerve gave three branches. Two of its branches pierced the external oblique aponeurosis, about 6 cm above the pubic symphysis, to supply the skin of the lower part of the anterior abdominal wall. Another branch pierced the conjoint tendon, in the medial part of the inguinal canal about 2 cm above the superficial inguinal ring. Knowledge of unusual path of these branches may be important to avoid injuries during the surgical repair of groin hernias. Further care should be taken while dealing with the conjoint tendon in the Bassini procedure.

Hypoplastic anterior tibial artery associated with continuation of fibular (peroneal) artery as dorsalis pedis artery: a case report / Arteria tibial anterior hipoplásica asociada con la continuación de la arteria fibular como arteria dorsal del pié: un reporte de caso

Arterial variations of distal parts of lower limb are well documented. However, continuation of fibular artery as dorsalis pedis artery is a rare finding. Unusual course and distribution of the anterior tibial artery and fibular artery were observed during routine anatomical dissection of the right lower limb of an approximately 40-year-old male cadaver. The arteries of the crural region arose from the popliteal artery, as usual. However the anterior tibial artery was hypoplastic. The fibular artery was larger than usual and crossed the lowest portion of the interosseous membrane and continued as dorsalis pedis artery. Posterior tibial artery had a normal course and distally divided into medial and lateral plantar arteries. The awareness of these variations is important to vascular surgeons while performing arterial reconstructions in femorodistal bypass graft procedures, and also to orthopaedic surgeons during surgical clubfoot release.

Las variaciones arteriales de las partes distales de los miembros inferiores están bien documentados. Sin embargo, la continuación de la arteria fibular como arteria dorsal del pie es un hallazgo raro. El curso y distribución inusual de la arteria tibial anterior y la arteria fibular se observaron durante la disección anatómica de rutina en el miembro inferior derecho del cadáver de un hombre de aproximadamente 40 años de edad. Las arterias de la región crural se originaron desde la arteria poplítea como es usual. Sin embargo, la arteria tibial anterior era hipoplásica. La arteria fibular era más grande de lo habitual, cruzó la porción más baja de la membrana interósea y se mantuvo como la arteria dorsal del pie. La arteria tibial posterior tuvo un curso normal; distalmente se dividió en las arterias plantares medial y lateral. El conocimiento de estas variaciones es importante para los cirujanos vasculares al realizar reconstrucciones arteriales en procedimientos de injerto de bypass femorodistal, y también para los cirujanos ortopédicos durante la liberación quirúrgica del pie zambo.