Anatomical Variations of Internal Iliac Artery and Internal Iliac Vein and their Clinical Significance

Pelvic cavity is bounded by three bilateral pairs of bones (pubis, ilium and ischium) and two posteriorly located bones (sacrum and coccyx). Different organs lie in complicated juxtaposition in the pelvic cavity, including vessels, nerves, muscles, urogenital organs, and the rectum. Such configurations of these organs are difficult to comprehend for many surgeons to perform advanced surgery for cancers that arise in urological, gynecological organs or rectal cancer. Also procedure like sacrectomies and lateral pelvic compartment exenterations, isolating the external and internal iliac veins within the presacral area is crucial to avoid inadvertent injury and severe hemorrhage. This study review anatomic variations of internal iliac artery and internal iliac vein and their clinical significance. We found some rare patterns, which should be considered during surgery. These will benefit our understanding of pelvic anatomy and enhance safety in performing radical surgery for treating pelvic diseases; increase knowledge regarding the internal iliac artery and its branches is helpful in applying ligatures safely during pelvic surgeries which is essential to minimize intraoperative blood loss and other complications