Abnormal obturator artery with ipsilateral inferior epigastric artery passed behind the femoral vein / Arteria obturatriz anómala con arteria epigástrica inferior ipsilateral que cruza posterior a la vena femoral

SUMMARY: Clear awareness of the vascular variations is critical in surgeries, which may cause massive hemorrhage during surgical procedures. During educational dissection of a male cadaver, we encountered a combined variation of the left obturator artery and ipsilateral aberrant inferior epigastric artery. The left obturator artery originated from the external iliac artery, then coursed inward, adherent to the superior pubic ramus. The left inferior epigastric artery originated from the femoral artery, and coursed behind the femoral vein. These anatomical variations shown in one person were extremely rare. This is particularly true with regard to these variations while performing pelvic and inguinal region surgeries.

El conocimiento claro de las variaciones vasculares es fundamental en las cirugías, ya que pueden causar una hemorragia masiva durante los procedimientos quirúrgicos. Durante la disección educativa de un cadáver de sexo masculino, encontramos una variación combinada de la arteria obturatriz izquierda y la arteria epigástrica inferior ipsilateral aberrante. La arteria obturatriz izquierda se originaba en la arteria ilíaca externa, luego discurrió hacia medial, adhiriéndose a la rama púbica superior. La arteria epigástrica inferior izquierda se originaba en la arteria femoral y discurría por detrás de la vena femoral. Estas variaciones anatómicas mostradas en una sola persona son extremadamente raras. Esto es importante de conocer estas variaciones cuando se realizan cirugías de las regiones pélvica e inguinal.

Variação anatômica venosa rara em membros inferiores / A rare venous anatomic variation of the lower limb

Resumo A anatomia do sistema venoso dos membros inferiores é uma das mais complexas no corpo humano. Devido a essa condição, é de extrema importância saber identificar variações que possam acometê-la, como as malformações congênitas. Em casos de agenesia de veias profundas, como uma malformação vascular rara, o quadro clínico pode manifestar-se com insuficiência venosa crônica, que pode evoluir com edema, hiperpigmentação e úlcera de membro inferior. Assim, em muitos casos, torna-se uma doença incapacitante e de difícil tratamento. Apresenta-se um caso de agenesia de segmento venoso femoropoplíteo no membro inferior direito em paciente de 36 anos de idade, que cursou com edema e varizes de grosso calibre no membro acometido.

Abstract The anatomy of the venous system of the lower limbs is among the most complex in the human body. In view of this, it is extremely important to know how to identify variations that can affect it, such as congenital malformations, for example. In cases of a rare vascular malformation such as agenesis of deep veins, clinical status may manifest with chronic venous insufficiency, which can progress with edema, hyperpigmentation, and lower limb ulcers. This is very often therefore an incapacitating disease that is difficult to treat. This article describes a case of agenesis of a segment of femoropopliteal vein in the right lower limb of a 36-year-old patient who had edema and large caliber varicose veins in the affected limb.

A rare variation of deep femoral vein.

Venous pattern particularly in the lower limbs is of great clinical importance, while ligating the veins to prevent the spread of thrombus. Normally deep femoral vein drains the area supplied by profunda femoris artery, follows the pattern of branches of this artery and ends independently into the femoral vein. However in few cases it establishes communication with popliteal vein of femoral vein at a lower level. In the present study the deep femoral vein replaced most of the popliteal vein by establishing communication with the tibial veins.