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Case report

Year :2021 Month : July-August Volume : 10 Issue : 3 Page : AC01 - AC02 Full Version

Aberrant Origin of Obturator Artery- A Case Report


Parul Upadhayay, Ranjeeta Hansdak, Sneh Agarwal
1. Senior Resident, Department of Anatomy, Lady Hardinge Medical College, Delhi, India. 2. Assistant Professor, Department of Anatomy, Lady Hardinge Medical College, Delhi, India. 3. Director Professor and Head, Department of Anatomy, Lady Hardinge Medical College, Delhi, India.
 
Correspondence Address :
Ranjeeta Hansdak,
A10/02/SF, Block A, BPTP Parkland, Sector-85, Greater Faridabad, Haryana, India.
E-mail: ranjeetahansdak@gmail.com
 
ABSTRACT

: The medial compartment of thigh is nourished by a branch from anterior division of internal iliac artery called Obturator Artery (OA). However, many studies have documented variation in the origin of the artery from other neighboring vessels. Hence, any deviation from the normal pattern should be acknowledged to prevent any injuries during herniorrhaphy or other pelvic procedures. The study was conducted on a pelvis of female cadaver of age 55 years. Length of the artery and its distance from the bifurcation of common iliac artery using the measuring tape were noted. OA was seen to be originating from the inferior epigastric artery bilaterally along with several unusual but significant branches budding from it. The case report shows variant of OA which is of academics interest to students, anatomists, radiologist, general and orthopedic surgeons. Further dissection of more number of pelvic specimens might help to assess the frequency or prevalence of the variation.
Keywords : External iliac artery, Herniorrhaphy, Inferior epigastric, Pelvis, Reconstruction
DOI and Others : 10.7860/IJARS/2021/46286:2666

Date of Submission: Aug 13, 2020
Date of Peer Review: Oct 17, 2020
Date of Acceptance: Dec 24, 2021
Date of Publishing: Jul 01, 2021

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was informed consent obtained from the subjects involved in the study? NA
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Aug 18, 2020
• Manual Googling: Aug 24, 2021
• iThenticate Software: Apr 06, 2021 (18%)

Etymology: Author Origin
 
Case Report

During routine dissection of pelvis of one adult female cadaver of 55 years for teaching undergraduate students in dissection hall of Lady Hardinge Medical College, Delhi; on the right hand side it was obseved that (Table/Fig 1) external iliac artery gave rise to two branches-deep circumflex iliac artery laterally at a distance of 7.8 cm from the point of bifurcation of common iliac artery. At the same level, a medial branch (inferior epigastric artery) was given off which after coursing for 2 cm bifurcated to give inferior epigastric artery proper and a large variant obturator artery. The artery coursed downwards, forwards and medially along the posterior surface of superior ramus of pubis for 5 cm. It then terminated by supplying the adductor compartment of thigh after passing through the obturator canal. At its exit, it was related to obturator vein and obturator nerve medially.

Similarly, on the left-side (Table/Fig 2), the external iliac artery gave two branches-deep circumflex iliac artery laterally at a distance of 6.1 cm from the point of bifurcation of common iliac artery and a medial branch (inferior epigastric artery) was given off 3.2 cm proximal to the lateral branch which after coursing for 1.7 cm bifurcated to give inferior epigastric artery proper and a large variant obturator artery. This 4.5 cm long variant obturator artery while coursing downwards, forwards and medially gave rise to 2-3 pubic branches; just before leaving the pelvic cavity through obturator canal the artery gave superior peritoneal branch and an inferior vaginal branch, and it itself terminated by supplying the medial compartment of thigh.

Throughout its course, both right and left variant of obturator artery were related to obturator internus and its fascia laterally and ureter medially. The internal iliac artery, obturator vein and obturator nerve displayed normal anatomy.
 
 
Discussion

During routine dissection of pelvis of one adult female cadaver of 55 years for teaching undergraduate students in dissection hall of Lady Hardinge Medical College, Delhi; on the right hand side it was obseved that (Table/Fig 1) external iliac artery gave rise to two branches-deep circumflex iliac artery laterally at a distance of 7.8 cm from the point of bifurcation of common iliac artery. At the same level, a medial branch (inferior epigastric artery) was given off which after coursing for 2 cm bifurcated to give inferior epigastric artery proper and a large variant obturator artery. The artery coursed downwards, forwards and medially along the posterior surface of superior ramus of pubis for 5 cm. It then terminated by supplying the adductor compartment of thigh after passing through the obturator canal. At its exit, it was related to obturator vein and obturator nerve medially.

Similarly, on the left-side (Table/Fig 2), the external iliac artery gave two branches-deep circumflex iliac artery laterally at a distance of 6.1 cm from the point of bifurcation of common iliac artery and a medial branch (inferior epigastric artery) was given off 3.2 cm proximal to the lateral branch which after coursing for 1.7 cm bifurcated to give inferior epigastric artery proper and a large variant obturator artery. This 4.5 cm long variant obturator artery while coursing downwards, forwards and medially gave rise to 2-3 pubic branches; just before leaving the pelvic cavity through obturator canal the artery gave superior peritoneal branch and an inferior vaginal branch, and it itself terminated by supplying the medial compartment of thigh.

Throughout its course, both right and left variant of obturator artery were related to obturator internus and its fascia laterally and ureter medially. The internal iliac artery, obturator vein and obturator nerve displayed normal anatomy.
 
 
Conclusion

Knowledge of presence of OA is of academic interest to students and anatomists as well as very useful in management of femoral hernia and pelvic surgeries during ligation or to avoid any serious complications. Branches of obturator artery also supply neck of femur; hence any variant pattern might also help orthopedic surgeons in planning surgeries.
 
REFERENCES
1.
Bergman RA, Thompson SA, Afifi AK, Saadeh FA. Compendium of human anatomic variations: Catalog, Atlas and World literature. Baltimore and Munic: Urban and Schwazenberg; 1988.   [Google Scholar]
2.
Arey LB. The Peripheral Blood Vessels. Baltimore: Williams & Wilkins; 1963. The development of peripheral blood vessels. In: Orbison JL, Smith DE (editors) Pp. 1-16.   [Google Scholar]
3.
Fitzerald MJT. Human Embryology. New York: Harper International; 1978. Pp. 38-56.   [Google Scholar]
4.
Biswas S, Bandopadhyay M, Adhikari A, Kundu P, Roy R. Variation of origin of obturator artery in Eastern Indian population- A study. J Anat Soc India. 2010;59(2):168-72. ?doi?https://doi.org/10.1016/S0003-2778(10)80019-X#doi#   [Google Scholar]  [CrossRef]
5.
Vishnumukkala Tr, Yalakurthy S, Raj SJD. An anomalous origin of obturator artery and its clinical importance in humans. Int J Anat Res. 2013;01:02-06.   [Google Scholar]
6.
Sanduno JR, Roig M, Rodriguez Aferreira B, Domenech JM. Rare origin of the obturator artery, inferior epigastric and femoral arteries from a common trunk. J Anat. 1993;183:161-63.   [Google Scholar]
7.
Kumar D, Rath G. Anomalous origin of obturator artery from the internal iliac artery. Int J Morphol. 2007;25(3):639-41. ?doi?https://doi.org/10.4067/S0717-95022007000300028#doi#   [Google Scholar]  [CrossRef]
8.
Rajive AV, Pillay M. A study of variations in the origin of obturator artery and its clinical significance. J Clin Diagn Res. 2015;9:12-15. ?doi?https://doi.org/10.7860/JCDR/2015/14453.6387#doi# ?pmid?26435935#pmid#   [Google Scholar]  [CrossRef]  [PubMed]
9.
Pai MM, Krishnamurthy A, Prabhu LV, Pai MV, Kumar SA, Hadimani GA. Variability in the origin of the obturator artery. Clinics (Sao Paulo). 2009;64(9):897-901. ?doi?https://doi.org/10.1590/S1807-59322009000900011#doi# ?pmid?19759884#pmid#   [Google Scholar]  [CrossRef]  [PubMed]
10.
Satheesha Nayak B. Presence of abnormal obturator artery and an abnormal venous plexus at the anterolateral pelvic wall. OA Case Reports. 2014;3(5):49.   [Google Scholar]
11.
Perandini S, Perandini A, Puntel G, Puppini G, Montemezzi S. Corona mortis variant of the obturator artery: a systematic study of 300 hemipelvises by means of computed tomography angiography. Pol J of Radiol. 2018;83:640-44. ?doi?https://doi.org/10.5114/pjr.2018.81441#doi# ?pmid?30800190#pmid#   [Google Scholar]  [CrossRef]  [PubMed]
12.
Darmanis S, Lewis A, Mansoor A, Bircher M. Corona mortis: an anatomical study with clinical implications in approaches to the pelvis and actabulum. Clin Anat. 2007;20(4):433-39. ?doi?https://doi.org/10.1002/ca.20390#doi# ?pmid?16944498#pmid#  [Google Scholar]  [CrossRef]  [PubMed]
 
 
 
 

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