Inferior epigastric artery arising from the obturator artery as a terminal branch of the internal iliac artery and consideration of its rare occurrence

Variant Origin of Obturator Artery: A Branch of Inferior Epigastric Artery from External Iliac Artery

“…Of these, the latter was very rare [4]. It is widely known that in cases when the obturator artery originates from the external iliac artery, it usually arises from the inferior epigastric artery [4][5][6][7][8][9][10]. The frequency of this variant obturator artery has been reported in several studies (Table 1).…”

“…It has been widely known that there is variation in the origin of obturator artery, which has been reported in cadaveric studies from several countries [4][5][6][7][8][9][10]. According to these reports, the obturator artery arises from the external iliac arterial system instead of the internal iliac artery in approximately 8 to 40% of cases.…”

“…Within the pelvis, the obturator artery gives off several branches, which supply the surrounding structures including the iliacus muscle and urinary bladder. After the obturator artery leaves the pelvic cavity through the obturator foramen and obturator canal, it supplies the adductor muscles of the thigh and head of the femur [1][2][3].It has been widely known that there is variation in the origin of obturator artery, which has been reported in cadaveric studies from several countries [4][5][6][7][8][9][10]. According to these reports, the obturator artery arises from the external iliac arterial system instead of the internal iliac artery in approximately 8 to 40% of cases.…”

Life-Threatening Bleeding from the Pubic Branch of the Inferior Epigastric Artery after Pubic Ramus Fracture

“…Continuing its course upward, the IEA pierces the transversalis fascia below the arcuate line and enters the rectus sheath to reach the deep surface of the rectus abdominis muscle. 5 Life-threatening arterial haemorrhage has mainly been reported in unstable pelvic fractures. 1 Cases of haemodynamic instability due to isolated pubic ramus fractures with arterial haemorrhage are extremely rare.…”

“…Sometimes, the pubic branch of the IEA anastomoses with the obturator branch of the internal iliac artery. 5 Wong et al 7 described a case with life-threatening pubic ramus fracture with the bleeding vessel arising from the internal iliac artery. It is therefore important to perform internal iliac arteriography after embolisation in such injuries to confirm that active bleeding does not persist from anastomoses with the obturator branch of the internal iliac artery.…”