Ligation of both Internal Iliac Arteries for Hæmorrhage in Hysterectomy for Carcinoma Uteri

Kelly, Howard A.

doi:10.1097/00000658-189407000-00039

Cited by 46 publications

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“…So for a successful ligation of the IIA, the operating surgeon should be cognizant of the level of origin, the level of division of the artery; unilateral or bilateral ligation of the IIA can be lifesaving in patients with massive postpartum hemorrhage, after vaginal and abdominal hysterectomy; in massive broad ligament hematoma, cervical carcinoma, and retroperitoneal bleeding after pelvic fractures, bilateral IIA ligation is done. In the present study, in 40 % specimens, variant branches were observed [6][7][8].…”

Section: Discussionsupporting

confidence: 51%

Anatomical Study on the Variations in the Branching Pattern of Internal Iliac Artery

et al. 2012

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The internal iliac artery (IIA) arises from the common iliac artery at the level of the sacroiliac joint. It descends as trunk, divides into anterior and posterior divisions. From the anterior division it gives superior vesical, obturator, middle rectal, inferior vesical, inferior gluteal, and internal pudendal arteries. In females, inferior vesical artery is replaced by vaginal artery and gives an additional branch, uterine artery. The branches from the posterior division are ilio lumbar, lateral sacral, and superior gluteal arteries. An accidental hemorrhage and neurovascular injuries are common due to erroneous interpretation of variant arteries during surgical procedures. Hence the present study has been undertaken with reference to highlight its clinical and surgical significances. The study included 50 human bisected pelvises irrespective of their side and sex. Formalin-fixed specimens were selected and the branching patterns of IIA were studied. The level of origin, length, and the branching pattern of the IIA were examined and tabulated. The present study highlighted the variation seen in the origin, division branches of the IIA. The detailed knowledge of morphology is essential for successful ligation of the IIA during acute hemorrhage. This will guide the interventional radiologist in intra-arterial procedures during arterial embolization for hemorrhage, control of pelvic fractures, during selective catheterization of the intraarterial chemotherapy, and embolization of the pelvic tumors.

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Section: Discussionsupporting

confidence: 51%

Anatomical Study on the Variations in the Branching Pattern of Internal Iliac Artery

et al. 2012

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“…(1) to control intraoperative bleeding from cervical cancer. Bilateral internal iliac artery ligation is a lifesaving procedure in post-partum hemorrhage.…”

Section: Introductionmentioning

confidence: 99%

Physiological Menstrual Rhythm and Fertility After Internal Iliac Artery Ligation

Srinivasan¹,

Sharma²,

Kharge³

2015

jemds

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AIMS AND OBJECTIVEBilateral internal iliac artery ligation is a useful skill for the management of life-threatening post-partum hemorrhage. The procedure is not without risks and long-term complications. This study was conducted to ensure documentation and reporting of pregnancies following bilateral hypogastric artery ligation in cases of post-partum hemorrhage. We also aimed to compare the menstrual function and reproductive outcome after bilateral internal iliac artery ligation done for atonic post-partum haemorrhage. DESIGNProspective Case Study. SETTING PARTICIPANTSTen cases of bilateral internal iliac artery ligation were done for atonic post-partum hemorrhage. Main outcome measures: The primary outcome was assessed as the resumption of menstruation, regular cycles, and ability to conceive after surgery. Secondary outcome was incidence of intrauterine growth retardation and recurrent post-partum hemorrhage in subsequent pregnancies. RESULTSThe mean duration of resumption of menstruation following internal iliac artery ligation was 3 months. Bilateral internal iliac artery ligation is preferred over unilateral ligation as the extensive collaterals from the contralateral side immediately fill the circulation. The cases of atonic post-partum hemorrhage may require B-Lynch sutures in addition to bilateral internal iliac artery ligation to regain tone. Successful pregnancy after bilateral internal iliac artery ligation occurred in three out of seven cases. In one case, there was intrauterine growth retardation in eighth month. The patient was admitted and closely monitored with Doppler scan. At 35 weeks of gestation, emergency lower segment caesarean section was done for absent diastolic flow. The preterm neonate was 2 kilograms. There was no post-partum hemorrhage in the subsequent gestation. CONCLUSIONBilateral internal iliac ligation is a safe procedure in trained hands. Most near miss cases of maternal mortality have been saved due to this life saving surgery. Modern specialization has resulted in loss of art in the practice of general gynecology. The surgery is simple and should be within the surgical expertise of main stream gynecology.

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“…It had not been used extensively in the appropriate moment 1 . As a result many a time the reproductive life of a young woman had to be compromised.…”

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confidence: 99%

“…Infact this had even resulted in the unfortunate loss of lives. This is one of the most effective methods of controlling post partum haemorrhage [1][2][3] .…”

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confidence: 99%

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Internal iliac artery ligation - A life saving procedure in Obstetrics and Gynaecology practice

Sarma¹

2018

OBGYN

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Ligation of both Internal Iliac Arteries for Hæmorrhage in Hysterectomy for Carcinoma Uteri

Cited by 46 publications

References 0 publications

Anatomical Study on the Variations in the Branching Pattern of Internal Iliac Artery

Anatomical Study on the Variations in the Branching Pattern of Internal Iliac Artery

Physiological Menstrual Rhythm and Fertility After Internal Iliac Artery Ligation

Internal iliac artery ligation - A life saving procedure in Obstetrics and Gynaecology practice

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