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

Abstract

An in-depth knowledge of the vascular anatomy of the female pelvis is crucial for any gyne-oncologic 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. (J GYNECOL SURG 36:149)