Rare origin of the obturator artery from the external iliac artery with two obturator veins

Abstract

The obturator artery is a branch of the internal iliac artery, although there are reports documenting variations, with origin from neighboring vessels such as the common iliac and external iliac arteries or from any branch of the internal iliac artery. It normally runs anteroinferiorly along the lateral wall of the pelvis to the upper part of the obturator foramen where it exits the pelvis by passing through said foramen. Along its course, the artery is accompanied by the obturator nerve and one obturator vein. It supplies the muscles of the medial compartment of the thigh and anastomoses with branches of the femoral artery on the hip joint. We report a rare arterial variation in a Brazilian cadaver in which the obturator artery arose from the external iliac artery, passing beyond the external iliac vein toward the obturator foramen, and was accompanied by two obturator veins with distinct paths. We also discuss its clinical significance.

Orthopedic Implications of the Corona Mortis: A Case Report

“…Variations of the OA and IEA are well described in the literature (Testut & Latarjet, 1958;Sañudo et al, 2011;Al Talalwah;Goke et al;Tubbs et al, 2016). CM incidence varies from 12 % to 40 % in most recent studies (Stavropoulou-Deli & Anagnostopoulou; Pellegrino et al; Baena et al; Al Talalwah; Tajra et al; Wada et al).…”

“…This begins during the fifth week of embryonic development (Jusoh et al, 2010;Schoenwolf et al, 2014;Goke et al, 2016).…”

Corona Mortis : anatomical and surgical description on 60 cadaveric hemipelvises

“…Vascular formation during the embryonic period consists of the appearance of vessels and anastomoses that may or may not persist during ontogenesis 10 .…”

“…Anatomical variations of the OA origin are described in detail in the literature: it may originate from the EIA, from an ischial-pudendal trunk (formed by the internal pudendal and lower gluteal arteries), the upper or lower gluteal arteries, the internal pudendal artery, the femoral artery and from two distinct roots (one from the EIA and another from the IIA) [1][2][3]10,11 . The OA can also originate from the IEA, ilium-lumbar artery, lower bladder artery, vaginal artery, accessory hemorrhoidal artery, external pudendal artery, accessory pudendal artery, prostatic artery, and internal pudendal artery 1,14 .…”

“…This anatomical variant is of clinical and surgical interest, as it is susceptible to iatrogenic lesions during hernia repairs, gynecological and orthopedic procedures, and may also be damaged in fractures of the pubis or acetabulum. The literature also reports the difficulty in performing CM hemostasis and the fact that this anatomical variation determines collateral circulation between EIA and the IIA [5][6][7][8][9][10] .…”