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This requires a tertiary care set up and surgical skills for retroperitoneal ligation of internal iliac artery ligation.
During the procedure decision for bilateral internal iliac artery ligation was taken and done, along with this continuous vault suturing done, haemostasis secured.
Out of 316 pelvises of formalin fixed adult cadavers studied it was observed that in one adult male cadaver in the department of Anatomy of Vardhman Mahavir Medical College and Safdarjung hospital, New Delhi, the left obturator artery was arising from the posterior division of internal iliac artery. The right side artery showed no variation of any sort, in its origin and course.
Normally, the internal iliac artery begins at the common iliac bifurcation, at the level of sacroiliac joint.
It is also helpful in massive broad ligament hematoma, in torn vessels retracted within the broad ligament Following ligation of internal iliac artery, there is a reduction of 85% in pulse pressure and 48% in the blood flow in the arteries distal to the ligation.
All surgical interventions namely internal iliac artery ligation and Cesarean total hysterectomy, except interrupted suture in placental site 2(6.7%), were found to be significantly absent in Group A than that of Group B (P value< 0.05) thereby avoiding possible complications arising from additional surgical interventions such as internal iliac ligation -4 (13.3%) and cesarean hysterectomy -10(33.4%)
Retroperitoneal dissection was done, ureter was visualized and retracted .The internal iliac artery was carefully dissected and separated from fragile internal iliac vein.
Internal iliac artery aneurysm resection in transplanted kidney.
Additional renal arteries can emerge from the abdominal aorta aloft the main branch or as low (inferiorly) as the internal iliac artery (13).
Open Surgery for Giant Bilateral Internal Iliac Artery Aneurysms with Compression of Neighboring Abdominal Structures: A Case Report.
An experienced operator performed the diagnostic angiogram using selective or superselective digital subtraction angiography, followed by the therapeutic intervention that consists of embolization of uterine artery branch or internal iliac artery branch.
When postpartum hemorrhage occurs during a cesarean delivery, there are many interventions that may successfully control the excessive blood loss, including uterotonics, massive transfusion of blood products, uterine massage, tranexamic acid, uterine devascularization, uterine compression sutures, intrauterine balloon tamponade, uterine artery embolization, uterine tourniquet, internal iliac artery ligation, hysterectomy, and pelvic packing.