An accessory obturator artery from the external iliac artery that runs along the posterior part of pubic bone or a pubic vein from the external iliac vein or an arterial branch from the inferior epigastric artery will be detected at the lateral border of that field during its path to obturator foramen
. Moreover, lateral to the bladder neck and urethra, nerves innervating the bladder and urethra and a venous plexus (Santorini plexus), (which could be injured during suture placement for Burch retropubic colposuspension) are found.
After the needle tip touched the inferior border of the superior pubic ramous, the needle was withdrawn shortly and then directed 45 degrees laterally to enter the obturator foramen
. Next, adductor muscle contraction was elicited by nerve stimulation, and 10 mL of 1% lidocaine was injected.
We present a unique case of open reduction and internal fixation of a high-energy femoral neck fracture with extrusion of the head through the obturator foramen
into the pelvis without associated acetabular or pelvic injury.
It was redirected laterally and slightly inferiorly to slip past the inferior ramus and just underneath the superior ramus of the pubic bone, then advanced an additional 11/2 inch to lie in the area of the obturator foramen
. Ten ml of 2% lignocaine inj.
Obturator artery is one of the parietal extrapelvic branches of the internal iliac artery, which runs along the lateral wall of the pelvis and passes through the obturator foramen
to reach and irrigate the medial region thigh muscles and the hip joint.
The subsequent computed tomography (CT) also demonstrated a small bowel loop herniating through the obturator foramen
, lying between the pectineus and obturator muscles [Figure 1]d.
The obturator internus originates from the rami surrounding the obturator foramen
and the quadrilateral plate and leaves the pelvis through the lesser sciatic notch before inserting on the greater trochanter of the proximal femur (4).
According to operative reports for these 2 patients, the needle passed through the obturator foramen
[6,7] Bowel herniating through the obturator foramen
and lying between the pectineus and obturator muscles is a key finding on CT and determines the diagnosis.
We still pass the needle all the way through a vaginal incision and out through the obturator foramen
, and we pull the sling into place as we would any other TOT sling.
The obturator nerve has a variable number of articular branches likely radiating from a common stem located lateral to the obturator foramen
inferior to the acetabulum (Figure 3).
The sina que non on CT is visualization of the bowel entering obturator canal through the obturator foramen
, which is inferior and lateral to the inguinal canal.