Rare Variant of Obturator Artery Branching from Posterior Division of Internal Iliac Artery

Abstract

Background: An in-depth knowledge of the vascular anatomy of the female pelvis is crucial for any gyneoncologic surgeon. No two patients are the same, hence it is possible to encounter anatomical variants while performing laparoscopic gyne-oncologic surgery. In this case, we would like to report a rare variant of obturator artery origin, arising as a Y-shaped trunk from the posterior division of the internal iliac artery. Case: A 58-year-old postmenopausal lady, with hypertension, degenerative disease of the knees, presented with abnormal uterine bleeding. Endometrial biopsy revealed atypical hyperplasia with grade 1 endometrioid carcinoma. Computed tomography scan showed an equivocal filling defect in the uterine cavity. Result: Patient underwent laparoscopic surgical staging with total hysterectomy, bilateral salpingo-oophorectomy, with bilateral pelvic lymphadenectomy for endometrial carcinoma. Surgeons encountered an unusual branching of obturator artery from the posterior division of internal iliac artery, resembling Y shape. Conclusion: Variants of obturator artery origin and anatomy is more common than thought, with reports in literatures ranging from 0.5% to 18% of cases. It is important to familiarize oneself with the variations as to avoid troublesome bleeding and complications during gyne-oncologic surgery.

Cluster of variations involving vertebral, renal, and obturator arteries in a single human body- A cadaveric case report

“…Whereas, the variant origin of the OA from the posterior division of the IIA was found to be ranging from 0.5% to 18% of the cases. 42 Pai et al also observed that OA can have a dual origin from both EIA and IIA, which was observed in 2% of the cases. 38 The average diameter of the OA ranges from 0.8 to 3.2 mm.…”

Cluster of variations involving vertebral, renal, and obturator arteries in a single human body- a cadaveric case report.

“…Pai et al AOA in 19% of the cases [23]. Whereas, the variant origin of the OA from the posterior division of the IIA was found to be ranging from 0.5-18% of the cases [7]. Pai et al also observed that OA can have a dual origin from both EIA and IIA, which was observed in 2% of the cases [23].…”