Inferior epigastric artery: Surface anatomy, prevention and management of injury

Abstract

The anatomical position of the inferior epigastric artery (IEA) subjects it to risk of injury during abdominal procedures that are close to the artery, such as laparoscopic trocar insertion, insertion of intra-abdominal drains, Tenckhoff(®) catheter (peritoneal dialysis catheter) and paracentesis. This article aims to raise the awareness of the anatomical variations of the course of the IEA in relation to abdominal landmarks in order to define a safer zone for laparoscopic ancillary trocar placement. Methods of managing the IEA injury as well as techniques to minimise the risk of injury to the IEA are reviewed and discussed.

Has the twin rate after in vitro fertilisation really decreased in Australia?

“…The absolute number of twin births after IVF was 163 per 100 000 live births in 1996, peaking at 361 in 2003, and by 2012 had reduced to 217. 1,4,10 Over the same period, the absolute number of ART cycles rose from 21 739 (6955 per 100 000 live births) in 1996, to 70 082 (18 888 per 100 000 live births) in 2012.…”

“…In 2012, there were 13 312 live twin births in Australia and New Zealand, out of a total of 371 039 live births (3.6%). [1][2][3] In comparison, in 1996 there were 3277 live twin births following IVF out of a total of 312 554 live births (0.89%). [4][5][6] Due to the initial low success rates of IVF, multiple embryo transfer became the standard, commonly resulting in multiple pregnancy.…”

“…9 This has resulted in SET rates climbing from 12.5% in 1996 to 76.3% in 2012. 1,4 Consequently, the rate of twin births out of all IVF deliveries, twin birth being a single count, was 18.1% in 1996, peaked at 21.1% in 2000, and fell to a low of 6.3% in 2012. 1,4,9,10 We studied the impact of the policy of implementation of SET on the absolute number of women who gave birth to twins in Australia and New Zealand.…”

“…1,4 Consequently, the rate of twin births out of all IVF deliveries, twin birth being a single count, was 18.1% in 1996, peaked at 21.1% in 2000, and fell to a low of 6.3% in 2012. 1,4,9,10 We studied the impact of the policy of implementation of SET on the absolute number of women who gave birth to twins in Australia and New Zealand. We analysed Australian Institute of Health and Welfare (AIHW) National Perinatal Epidemiology and Statistics Unit's annual reports on Australia's mothers and babies as well as assisted reproductive technology in Australia and New Zealand reports.…”

A 54-Year-Old Woman With a History of Alcoholic Cirrhosis and Recurrent Ascites Presenting With Abdominal Pain and Increasing Abdominal Girth

“…However, this does not take into account branches of the IEA whose course can be quite variable, even extending toward recommended puncture sites. [8][9][10] Other vessels coursing along the abdominal wall in areas where paracentesis may be performed include the superficial epigastric and superficial circumflex iliac arteries. 6 Most often used to ensure that underlying bowel is sufficiently distant from the paracentesis needle, ultrasound can also identify other potentially nearby structures such as the liver, spleen, and bladder.…”