scholarly journals Congenital Anatomical Variant with Cranial Origin of Internal Iliac Arteries

Aorta ◽  
2021 ◽  
Author(s):  
Umberto G. Rossi ◽  
Anna M. Ierardi ◽  
Maurizio Cariati

AbstractWe report the case of a 73-year-old male who underwent abdominal multidetector computed tomography with vascular reconstruction that highlighted a congenital variant of iliac arteries. Iliac artery anatomical variants are exceedingly rare and only a few cases have been reported in the literature.

Author(s):  
Shashi Lata Kabra Maheshwari ◽  
Nisha Kumari ◽  
Syed N. Ahmad

Background: Massive pelvic haemorrhage is a potentially lethal complication while undergoing obstetric and gynaecological surgery. The objective of this study was to study of role of bilateral internal iliac artery ligation in severe obstetric and gynaecological haemorrhage. It was a prospective interventional study carried out in a multi-speciality tertiary care hospital in New Delhi.Methods: Thirty-five patients (31 obstetric and 4 gynaecological) fulfilling the inclusion criteria over a period of 2 years were included in the study cohort after informed consent. After laparotomy, internal iliac arteries were exposed by incising the peritoneal fold between the infundibulo-pelvic and round ligaments. A number 1 silk suture and right-angled artery forceps were used to tie the internal iliac arteries approximately 1 inch below their origin. The success and complications of the procedure were analysed.Results: In the present study 31 out of 35 cases underwent BIIAL for obstetrical cause of haemorrhage and rest 4 for gynaecological cause. In 19 out of 31 patients, hysterectomy preceded or followed BILAL depending upon the clinical situation making a uterine salvation rate of 38.7%. The success rate of BIIAL was 67.7% in 31 obstetric cases. In the 4 gynaecological cases BILAL was done to arrest post-hysterectomy haemorrhage and success rate was 100%. Among 35 patients one patient died of haemorrhagic shock and 4 other died of full blown sepsis and MODS in surgical ICU. No significant procedure related complications were encountered.Conclusions: BILAL is a very effective procedure to control PPH and pelvic haemorrhage due to other causes and helps save the much precious lives and uteri. This procedure can always be tried where procedures like embolization are unavailable.


2014 ◽  
Vol 20 (4) ◽  
pp. 219-227
Author(s):  
Oana Popa ◽  
P. Bordei ◽  
D. Iliescu ◽  
C. Ionescu

Abstract The origin of the internal iliac artery, right and left, was studied in 76 cases, 58 cases of male (76.32% of all cases) and 18 female cases (23.68% of all cases). The origin of the internal iliac arteries was considered in relation to the spine (lumbar-sacral). The right internal iliac artery males originates in a range from the upper edge of L4 vertebra - the lower part of fin sacral. It is found that in males, in most cases, 43 cases (74.14% of male cases), right internal iliac artery originates at different levels of sacral fin. We considered that the right iliac artery low origin only the cases in the lower part of the fin sacral, 10 cases (17.24% of male cases). Cases of high origin of the artery, above the fin sacral we found it in 15 cases (25.86% of male cases). From high origins, in the upper edge of the L4 vertebra and intervertebral disc at L4-L5, I met only one single case. Right internal iliac artery in females originated in a range between the upper edges of L5 - the lower part of sacral fin. In females, the right internal iliac artery origin, is located within narrower than in men, but in women, most frequently, 14 cases (77.78% of female the cases) was the origin of the internal iliac located at different levels of sacral fin. The females have not met internal iliac origin above the L5 vertebra or intervertebral disc level L4-L5. High origin was met it in 4 cases (22.22% of female the cases) and low origin in 6 cases (33.33% of female the cases). The level of the left internal iliac artery origin we studied 78 cases, finding it in the same range as in males, i.e., the upper edge of L4 vertebra - the front of the sacrum. In males, on a number of 57 cases (73.08% of all cases) the origin of the left internal iliac artery was made between the upper edge of the vertebra L4 - the front face of the sacrum, most commonly, in 44 cases (77 19% of male the cases) located in the sacral fin. The artery high origin I found it in 9 cases (15.79% of male the cases) and low origin in 18 cases (31.58% of male the cases). I have not met artery origin at L5-S1 intervertebral disc. In terms of low origin, only in males, the left internal iliac artery originated from the anterior to the sacrum, something not found the right internal iliac artery. In females, the 18 cases followed, had their origins in the range lower half of the L5 - middle sacral fin, 17 cases (94.44% of female the cases), terminating at the sacral fin. It is found that in women the origin of the left internal iliac artery is within narrower than the other cases described so far, showing the highest level of origin, this artery in females do not possess low origin. The high origin is present in a small percentage, only 5.56% of cases, encountering any case the origin of the left internal iliac artery is located at the L4 vertebra or the intervertebral discs at L4-L5 or L5-S1. Internal iliac artery diameter was followed on 90 cases, 44 cases for the right internal iliac artery and 46 cases for left internal iliac artery. In males, the right internal iliac artery I found a caliber between 3 to 9.8 mm. In women the right internal iliac artery caliber found between 3.9 to 6.9 mm.


2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Michael Herskowitz ◽  
James Walsh ◽  
Meghan Lilly ◽  
Kimberly McFarland

Transcatheter angiography and embolization has long been recognized as the gold standard for patients with hemodynamic instability secondary to blunt pelvic trauma. While often the bleeding source can be readily localized based on the distribution of extravasation on preprocedural Computed Tomographic Angiography, one should be cautious in assessment for aberrant anatomy. A variant obturator artery originating from the inferior epigastric branch of the external iliac artery is commonly referred to as the corona mortis. We present a case of blunt pelvic trauma in which a patient demonstrated extravasation in the anterior distributions of both internal iliac arteries. Following embolization of bilateral internal iliac arteries, identification and embolization of bilateral corona mortis branches was crucial to achieving hemodynamic stability in this patient.


2018 ◽  
Vol 177 (4) ◽  
pp. 67-72
Author(s):  
A. Ya. Bedrov ◽  
A. A. Moiseev ◽  
A. V. Belozertseva ◽  
A. N. Morozov ◽  
Yu. A. Pugachenko

The  OBJECTIVE   is  to  assess the  patency  of  the  inferior  mesenteric artery   and   internal   iliac  arteries in  the  remote period  after  resection of the  aneurysm of the  infrarenal  aortic  segment. MATERIAL AND METHODS.  The  study  included 33  patients who  underwent resection  of  the  abdominal aortic  aneurysm with  reconstruction of  the  inferior  mesenteric artery  and  (or)  internal  iliac  arteries from  1998  to  2017.   All patients were  examined with  computed  tomography scan with  contrast to  assess the  patency of  inferior  mesenteric artery  and   internal  iliac  arteries. RESULTS.   Patients  were observed from  0.5  to  15  years. Among  30  patients with  inferior  mesenteric artery   implanted  into  the  prosthesis,  23 (76  %)  patients had  a  passable inferior  mesenteric artery  and  7  patients had  an  occluded inferior  mesenteric artery. The  implanted  inferior  mesenteric artery   maintained its  patency for  3  years in  100%   of  cases, from  3  to  5  years  – in  86%,  after  5  years and   more   –  in  62%.  In  one   patient   who  underwent  reconstruction  of  the  internal   iliac  artery, thrombosis  of  the  prosthetic-internal  iliac  shunt   was   found  out  in  1.5  years  after  the  operation,  without  any  clinical manifestations. One  patient,  underwent the  reconstruction of the  internal  iliac artery,  was  diagnosed with thrombosis of the prosthetic-internal iliac  shunt   in  1.5  years after  the  operation, which  was   not  accompanied by  clinical  manifestations. CONCLUSION.  The  high  remote patency of the  inferior mesenteric artery  and  internal  iliac arteries reconstructed during resection of the aneurysm of the infrarenal aortic segment indicates the need for this procedure in order to prevent ischemic disorders of the digestive organs and pelvis.


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