Analysis of Variation in the Origin of the Obturator Artery in Midwestern American Donor Bodies

Abstract

The obturator artery (OA) is typically a branch of the anterior division of the internal iliac artery. However, an aberrant obturator artery origin may lead to clinical complications. Because of its location in the pelvic cavity, the OA is at high risk of injury or laceration during a variety of pelvic surgeries. Regarding this, variations in the origins of the OA may result in bleeding that can often be overlooked, rendering treatment ineffective. Our study aimed to assess the origins and course of the OA in Midwestern American donor bodies. Sixty-two donor bodies were obtained from the Gift of Body Donation Program at A.T. Still University's Kirksville College of Osteopathic Medicine. The origin of each OA was documented and photographed. The OA was identified by observing the vessel's passage through the obturator foramen. Of 132 OAs studied, 72 (54.5%) had an aberrant OA. Further, 22 (16.7%) had an aberrant OA origin from the inferior epigastric artery, 20 (15.2%) had an aberrant OA origin from the posterior division of the internal iliac artery, 22 (16.7%) had an aberrant OA origin from dual origins of the anterior division of the internal iliac artery and the inferior epigastric artery, and eight (6.1%) had other aberrant OA origins. Overall, our results indicated anatomical variations are common in the origins and course of the OA. These data highlight the importance of considering variations in the OA and the prevalence of those variations during vascular and orthopedic procedures.

Keywords: anatomical variation; obturator artery; pelvic surgery; pelvic vasculature; pelvis.

Figure 1. Typical anatomy of the obturator artery (OA, yellow) originating from the anterior division of the internal iliac artery (AIIA, pink pin).

As shown, the OA anatomy typically originates from the anterior division of the IIA; the OA (yellow label) arises from the anterior division of the IIA (pink pin indicates AIIA). The image is from a male donor body, right hemipelvis. Abbreviations: IIA, internal iliac artery; EIA, external iliac artery; ON, obturator nerve; PIIA, posterior division of the IIA

Figure 2. The obturator artery (OA) originates from the posterior division of the internal iliac artery (PIIA).

As shown, the anterior and posterior divisions of the IIA originated from the IIA. Specifically, the OA (yellow label) originates from the posterior division of the IIA. The image is from a female donor body, right hemipelvis. Abbreviations: IIA, internal iliac artery; AIIA, anterior division of IIA; EIA, external iliac artery; ON, obturator nerve

Figure 3. Aberrant obturator artery (OA) originating from the inferior epigastric artery (IEA).

The OA (yellow label and a probe) originates from the IEA. As the probe indicates, OA is accompanied by the obturator vein (OV). The image is from a female donor body, right hemipelvis. Abbreviations: IIA, internal iliac artery; EIA, external iliac artery; ON, obturator nerve

Figure 4. Dual aberrant obturator arteries (OAs) originate from the anterior division of the internal iliac artery (AIIA) and the inferior epigastric artery.

Dual OAs (yellow labels) were observed in 11 pelvic halves. The first OA had typical anatomy originating from the anterior division of the IIA. The second OA is marked with a green pin and originated from the inferior epigastric artery. The image is from a female donor body, left hemipelvis Abbreviations: IIA, internal iliac artery; EIA, external iliac artery; ON, obturator nerve.