In this case, we were able to utilize this balloon occlusion technique to embolize an unselectable obturator artery in the setting of pelvic trauma.
(b) Digital subtraction angiography of the right internal iliac artery demonstrates a few foci of active contrast extravasation from the presumed internal pudendal artery (open white arrowheads) and obturator artery (open black arrowheads), compatible with hemorrhage secondary to traumatic laceration.
Rare origin of the
obturator artery from the external iliac artery with two obturator veins.
Yoshinaga, "Life-threatening haemorrhage following
obturator artery injury during transurethral bladder surgery: a sequel of an unsuccessful obturator nerve block," Acta Anaesthesiologica Scandinavica, vol.
The nerve to obturator externus muscle, arising from the intrapelvic obturator nerve before it splits into divisions, crosses the
obturator artery and descends between the obturator vessels.
The anterior branch of the
obturator artery, which runs along the exterior edge of the obturator foramen, is the structure of most concern.
An aberrant (accessory
obturator artery), a variation, may arise from the external iliac artery and runs to the obturator foramen.
It also arises with
obturator artery as a common trunk from the external iliac artery (Standring).
[25] reported the origin of prostatic arteries as follows: internal pudendal artery (56%), common gluteal-pudendal trunk (28%),
obturator artery (12%), and inferior gluteal artery (4%).
According to Rusu et al., there is no consensus regarding the terminology for these variant vessels emerging from the system of the external iliac artery, since authors as Mahato (2009) refer to the AOA as corona mortis artery in the absence of the
obturator artery. The truth is that these two forms of variation pose a risk in surgical procedures involving the inferior part of the anterior abdominal wall, because vessels run above and behind the superior pubic ramus (Baena et al.).
The present report demonstrates
obturator artery to be arising from the posterior division of internal iliac artery out of 316 pelvises, a rare observation in Indian population.
The anterior trunk gives superior vesical artery, inferior vesical artery, middle rectal artery, vaginal artery,
obturator artery, uterine artery, internal pudendal artery and inferior gluteal artery.