Obturator vein
By : Banan AlzubaidiDefinition :
. Obturator vein (venae obturator) : it is one of the veins in the pelvis and in the
back of the thigh.
. It is formed by the union tributaries, drains the hip joint and the obturator and
the adductor muscles (muscles of the upper and back of the thigh).
. In the normal cases ...It drains in the internal iliac vein (located deep to
the pelvic bone and extends to the lower abdomen ).
. The obturator vein receives the tributaries that correspond the branches
of the obturator artery.
back of the thigh.
. It is formed by the union tributaries, drains the hip joint and the obturator and
the adductor muscles (muscles of the upper and back of the thigh).
. In the normal cases ...It drains in the internal iliac vein (located deep to
the pelvic bone and extends to the lower abdomen ).
. The obturator vein receives the tributaries that correspond the branches
of the obturator artery.
Notes :
. Note: in the 47% of the people, it is found that the obturator vein is
the most inferior structure of the obturator neurovascular.
. Note: this vein may be exposed to an injury during the abdominal
surgery, especially during the femoral hernia repair.
. Note: the doctor often faces difficulty in accessing this vein to treat
the disease, especially in patients who suffer from congenital heart
problems (who have undergone several cardiac catheterization
operations).
. Note: the obturator vein may contribute to bleeding complications
during gynecological surgery.
the most inferior structure of the obturator neurovascular.
. Note: this vein may be exposed to an injury during the abdominal
surgery, especially during the femoral hernia repair.
. Note: the doctor often faces difficulty in accessing this vein to treat
the disease, especially in patients who suffer from congenital heart
problems (who have undergone several cardiac catheterization
operations).
. Note: the obturator vein may contribute to bleeding complications
during gynecological surgery.
Course and Relation :
. It begins in the upper border of the adductor (medial )region of the thigh
and enters the pelvic cavity by passing through the upper part of the
obturator foramen (obturator canal).
. It travels backward and forward on the lateral wall of the pelvic cavity and
passes between the ureter and the internal iliac artery.
. It is accompanying the obturator artery.
. It has anterior and posterior branches(similar to obturator artery).
. In some people, the obturator vein is single, in others it may be divided into
branches.
and enters the pelvic cavity by passing through the upper part of the
obturator foramen (obturator canal).
. It travels backward and forward on the lateral wall of the pelvic cavity and
passes between the ureter and the internal iliac artery.
. It is accompanying the obturator artery.
. It has anterior and posterior branches(similar to obturator artery).
. In some people, the obturator vein is single, in others it may be divided into
branches.
variation :
. Aberrant obturator vein : It is any anatomical variant or abnormal
deviation in the obturator vein that may be one abnormal in most patients
and may be bilateral in some patients and (may be found in the only right
side or only in the left side or in the both side of the humans body ).
. It is important to know the anatomical difference of the obturator vein in
order to benefit from it from an anatomical, radiological and surgical point
of view.
. Bleeding that is difficult to control may occur, which hinders the surgeon
from performing the required due to the presence of abnormal obturator
veins.
deviation in the obturator vein that may be one abnormal in most patients
and may be bilateral in some patients and (may be found in the only right
side or only in the left side or in the both side of the humans body ).
. It is important to know the anatomical difference of the obturator vein in
order to benefit from it from an anatomical, radiological and surgical point
of view.
. Bleeding that is difficult to control may occur, which hinders the surgeon
from performing the required due to the presence of abnormal obturator
veins.
classification of the aberrant obturator vein :
. Type 1) The aberrant obturator vein drains in the inferior epigastric vein.
. Located : medial to the deep femoral ring.
. Type 2) The the aberrant obturator vein drains in the inferior epigastric vein.
. Located : lateral to the deep femoral ring.
. Type3) The aberrant obturator vein drains in the external iliac vein.
. Type 4) The double aberrant obturator vein drains in the external iliac vein.
. In the some case (rare ), the pubic vein replacing the obturator vein and
draining in the external iliac vein.
. In most patients, the obturator vein drainage is symmetrical on both sides of
the body..in some patients, it is asymmetrical on both sides of the body ..like:
. In the case of symmetry,like :
. 1)the obturator vein drains in the internal iliac vein in the both sides of the
body .
. 2)the aberrant obturator vein drains in the internal obturator vein and external
vein in the both sides of the body.
. In the case if asymmetric ,like:
. 1) the aberrant obturator vein drains in the internal iliac vein in the one side
and in the other side drains in the internal iliac vein and external iliac vein.
. 2)the aberrant obturator vein drains in the external iliac vein in the one side
and in the other side drains in the internal iliac vein and external iliac vein .
. 3) the aberrant obturator vein drains in the internal iliac vein in the one side
and in the other side drains in the external iliac vein.
. Located : medial to the deep femoral ring.
. Type 2) The the aberrant obturator vein drains in the inferior epigastric vein.
. Located : lateral to the deep femoral ring.
. Type3) The aberrant obturator vein drains in the external iliac vein.
. Type 4) The double aberrant obturator vein drains in the external iliac vein.
. In the some case (rare ), the pubic vein replacing the obturator vein and
draining in the external iliac vein.
. In most patients, the obturator vein drainage is symmetrical on both sides of
the body..in some patients, it is asymmetrical on both sides of the body ..like:
. In the case of symmetry,like :
. 1)the obturator vein drains in the internal iliac vein in the both sides of the
body .
. 2)the aberrant obturator vein drains in the internal obturator vein and external
vein in the both sides of the body.
. In the case if asymmetric ,like:
. 1) the aberrant obturator vein drains in the internal iliac vein in the one side
and in the other side drains in the internal iliac vein and external iliac vein.
. 2)the aberrant obturator vein drains in the external iliac vein in the one side
and in the other side drains in the internal iliac vein and external iliac vein .
. 3) the aberrant obturator vein drains in the internal iliac vein in the one side
and in the other side drains in the external iliac vein.
Notes :
. Note: in rare cases, the absence of the formation of the internal iliac vein on one
side of the body has been found when the obturator vein drains directly into the
inferior vena cava.
. Note: in rare cases, two pubic veins are found on one side of the body.
. Note: the aberrant obturator vein that drains in the external iliac vein is
dangerous in the burch procedure(it is a surgical procedure to treat stress
urinary incontinence)because it causes a lot of bleeding.
side of the body has been found when the obturator vein drains directly into the
inferior vena cava.
. Note: in rare cases, two pubic veins are found on one side of the body.
. Note: the aberrant obturator vein that drains in the external iliac vein is
dangerous in the burch procedure(it is a surgical procedure to treat stress
urinary incontinence)because it causes a lot of bleeding.
Clinical point :
. In some cases, complications ( retroperitoneal hematoma in the pelvis)
related to a progress of a large diameter long sheath into the obturator
vein may occur in an adult with a previously thrombosed femoral vein and
the obturator vein was inadvertently cannulated.... during percutaneous
pulmonary valve implantation.
. obturator hook sign : it is a dilated vein..oblique..like a hook, which indicates
the congestion of the obturator vein,it is determined by the venous CT and is an
indirect sign of the obstruction of the outflow of the chronic iliac vein.
related to a progress of a large diameter long sheath into the obturator
vein may occur in an adult with a previously thrombosed femoral vein and
the obturator vein was inadvertently cannulated.... during percutaneous
pulmonary valve implantation.
. obturator hook sign : it is a dilated vein..oblique..like a hook, which indicates
the congestion of the obturator vein,it is determined by the venous CT and is an
indirect sign of the obstruction of the outflow of the chronic iliac vein.
References of images :
Cover image /obturator vein /ScienceDirect/https://www.sciencedirect.com/science/article/pii/S2213333X19304937
1)obturator vein /ResearchGate /https://www.researchgate.net/figure/An-obturator-vein-draining-directly-into-the-internal-iliac-vein-and-a-branch-arising_fig3_316278933
2)obturator vein /View Image /https://www.jasi.org.in/viewimage.asp?img=JAnatSocIndia_2019_68_2_105_269040_f1.jpg
3)obturator vein /Science Photo Library /https://www.sciencephoto.com/keyword/pudendal-venous-plexus
4)Aberrant obturator vein classification/ResearchGate/https://www.researchgate.net/figure/Aberrant-obturator-vein-classification-Type-I-aberrant-obturator-vein-drains-in-the_fig3_344204485
5)obturator vein /ScienceDirect/https://www.sciencedirect.com/science/article/pii/S002013831630136X
6)obturator vein /AMBOSS/https://www.amboss.com/us/knowledge/Pelvis_and_hip_joint
1)obturator vein /ResearchGate /https://www.researchgate.net/figure/An-obturator-vein-draining-directly-into-the-internal-iliac-vein-and-a-branch-arising_fig3_316278933
2)obturator vein /View Image /https://www.jasi.org.in/viewimage.asp?img=JAnatSocIndia_2019_68_2_105_269040_f1.jpg
3)obturator vein /Science Photo Library /https://www.sciencephoto.com/keyword/pudendal-venous-plexus
4)Aberrant obturator vein classification/ResearchGate/https://www.researchgate.net/figure/Aberrant-obturator-vein-classification-Type-I-aberrant-obturator-vein-drains-in-the_fig3_344204485
5)obturator vein /ScienceDirect/https://www.sciencedirect.com/science/article/pii/S002013831630136X
6)obturator vein /AMBOSS/https://www.amboss.com/us/knowledge/Pelvis_and_hip_joint
