OBJECTIVEObserve the course,distribution and variation of inferior gluteal artery to provide an anatomic basis.

METHODS18 specimen (11 male and 7 female. 9 left and 9 right) were perfused with red latex to show inferior gluteal arteries and the tissue around them.

RESULTSUsually inferior gluteal artery travels through infrapiriform foramen and goes down along ischiadicus nerve. It gives three main branches as ramus of articularis, ramus of ischiadicus, ramus of muscularis at average distances of 17.3 mm, 33.2 mm and 51.8 mm to infrapiriform foramen and nourishes them respectively. However, variation was found in 7 of 18 specimen (5 are female) .

CONCLUSIONSThe course of inferior gluteal artery is steady in most cases, but sometimes variation can be found. Special examinations such as colour Doppler ultrasound are suggested to find the course of inferior gluteal artery on the whole level before operation.

Arteries ; anatomy & histology ; Buttocks ; blood supply ; Female ; Humans ; Male ; Pelvis ; blood supply ; Surgical Flaps ; blood supply

In order to study the angiogenesis in endometriosis, the samples of eutopic and ectopic endometria from patients with endometriosis were quantitatively analyzed by color morphometric image system (CMIS) for vascular surface area, and by examining endometrial blood vessel for microvessel density (MVD). The results showed that within each menstrual phase the vascular surface area and MVD were significantly higher in ectopic endometria with endometriosis than those in eutopic endometria with endometriosis or normal endometrium (P < 0.05). It is concluded that angiogenesis might be involved in the development of endometriosis.
Adult ; Endometriosis ; etiology ; pathology ; Endometrium ; blood supply ; Female ; Humans ; Menstrual Cycle ; Neovascularization, Pathologic ; Pelvis

In order to study the angiogenesis in endometriosis, the samples of eutopic and ectopic endometria from patients with endometriosis were quantitatively analyzed by color morphometric image system (CMIS) for vascular surface area, and by examining endometrial blood vessel for microvessel density (MVD). The results showed that within each menstrual phase the vascular surface area and MVD were significantly higher in ectopic endometria with endometriosis than those in eutopic endometria with endometriosis or normal endometrium (P < 0.05). It is concluded that angiogenesis might be involved in the development of endometriosis.
Endometriosis/etiology ; Endometriosis/*pathology ; Endometrium/*blood supply ; Menstrual Cycle ; *Neovascularization, Pathologic ; *Pelvis

OBJECTIVETo provide detailed information of corona mortis for ilioinguinal approach as an anterior approach to the acetabulum and pelvis.

METHODSThe course, branches and distribution of the vascular connection between the obturator system and the external iliac or inferior epigastric systems located over the superior pubic ramus were observed on 50 hemipelvises with intact soft tissues.

RESULTSDuring the dissections, 72% of the cadaveric sides had at least one communicating vessel between the obturator system and the external iliac or inferior epigastric systems on the superior pubic ramus. The average diameter of the connecting vessel was 2.6 mm (range, 2.0-4.2 mm). It coursed over the superior pubic ramus or iliopubic eminence vertically to enter the obturator foramen and exit the pelvis. The average distance from pubic symphysis to the vascular connections between the obturator and external iliac systems was 52 mm (range, 38-68 mm).

CONCLUSIONSVascular connections between the obturator system and the external iliac or inferior epigastric systems were found over the superior pubic ramus with a high incidence. They are prone to damage during the ilioinguinal approach as an anterior approach to the acetabulum and pelvis. Thus, corona mortis located over the superior pubic ramus deserves great attention during the ilioinguinal approach.

Adult ; Aged ; Epigastric Arteries ; anatomy & histology ; Female ; Humans ; Iliac Vein ; anatomy & histology ; Male ; Middle Aged ; Obturator Nerve ; anatomy & histology ; Pelvis ; blood supply ; Pubic Symphysis ; blood supply

A 31-year-old man presented with painless gross hematuria. His serum-creatinine level was within the normal range. Abdominopelvic CT showed an infrahepatic calcified fibrous cord, which was suggestive of inferior vena cava (IVC) remnant. Extensive venous collateralization around both kidneys and venous drainage of the extremities via the inferior epigastric and internal thoracic veins were shown. We report a case of chronic post-thrombotic obstruction of the IVC, involving both renal veins, which was believed to be the cause of painless gross hematuria from mucosal varices of the pelviureteral system in normal functioning kidney.
Adult ; Hematuria/etiology ; Human ; Kidney/physiopathology ; Male ; Mucous Membrane/blood supply ; Pelvis/blood supply ; Renal Veins ; Thrombosis/*complications ; Ureter/blood supply ; Varicose Veins/complications ; Vascular Diseases/*etiology ; *Vena Cava, Inferior

A 31-year-old man presented with painless gross hematuria. His serum-creatinine level was within the normal range. Abdominopelvic CT showed an infrahepatic calcified fibrous cord, which was suggestive of inferior vena cava (IVC) remnant. Extensive venous collateralization around both kidneys and venous drainage of the extremities via the inferior epigastric and internal thoracic veins were shown. We report a case of chronic post-thrombotic obstruction of the IVC, involving both renal veins, which was believed to be the cause of painless gross hematuria from mucosal varices of the pelviureteral system in normal functioning kidney.
Adult ; Hematuria/etiology ; Human ; Kidney/physiopathology ; Male ; Mucous Membrane/blood supply ; Pelvis/blood supply ; Renal Veins ; Thrombosis/*complications ; Ureter/blood supply ; Varicose Veins/complications ; Vascular Diseases/*etiology ; *Vena Cava, Inferior

OBJECTIVE: We retrospectively assessed the results of performing ethanol embolization for pelvis arteriovenous malformations (AVMs). MATERIALS AND METHODS: During the past 10 years, eight patients (8 females, age range: 27-52 years) with AVMs in the pelvic wall (n = 3) and uterus (n = 5) underwent staged ethanol embolizations (range: 1-5, mean: 2.5) under general anesthesia. Ethanol embolization was performed by the use of the transcatheter and/or direct puncture techniques. Clinical follow-up was performed for all of the patients, and imaging follow-up was available for seven patients. The therapeutic outcomes were established by evaluating the clinical outcome of the signs and symptoms, as well as the degree of devascularization observed on post-procedural angiography. RESULTS: During the 20 sessions of ethanol embolization, the solitary transarterial approach was used 14 times, the transvenous approach was used three times and direct puncture was used once. For two patients, the transarterial and transvenous or direct puncture approaches were used together in one session. For four patients, ethanol and coils were used as embolic agents, and n-butyl cyanoacrylate (NBCA) and ethanol were used in one patient. Seven (88%) of eight patients were cured of their AVMs and one patient (12%) displayed improvement. Major complications were seen in two patients (25%). CONCLUSION: Ethanol embolization is effective for the treatment of pelvic arteriovenous malformations, though there is a chance of a major complication.
Adult ; Arteriovenous Malformations/*therapy ; Embolization, Therapeutic/adverse effects/*methods ; Enbucrilate/administration & dosage ; Ethanol/administration & dosage ; Female ; Humans ; Middle Aged ; Pelvis/*blood supply ; Retrospective Studies ; Solvents/administration & dosage ; Tissue Adhesives/administration & dosage ; Uterus/*blood supply

OBJECTIVETo explore the common types of massive intraoperative bleeding, clinical characteristics, treatment philosophy and operating skills in pelvic cancer surgery.

METHODSWe treated massive intraoperative bleeding in 19 patients with pelvic cancer in our department from January 2003 to March 2012. Their clinical data were retrospectively analyzed. The clinical features of massive intraoperative bleeding were analyzed, the treatment experience and lessons were summed up, and the operating skills to manage this serious issue were analyzed.

RESULTSIn this group of 19 patients, 7 cases were of presacral venous plexus bleeding, 5 cases of internal iliac vein bleeding, 6 cases of anterior sacral venous plexus and internal iliac vein bleeding, and one cases of internal and external iliac vein bleeding. Six cases of anterior sacral plexus bleeding and 4 cases of internal iliac vein bleeding were treated with suture ligation to stop the bleeding. Six cases of anterior sacral and internal iliac vein bleeding, one cases of anterior sacral vein bleeding, and one case of internal iliac vein bleeding were managed with transabdominal perineal incision or transabdominal cotton pad compression hemostasis. One case of internal and external iliac vein bleeding was treated with direct ligation of the external iliac vein and compression hemostasis of the internal iliac vein. Among the 19 patients, 18 cases had effective hemostasis. Their blood loss was 400-1500 ml, and they had a fair postoperative recovery. One patient died due to massive intraoperative bleeding of ca. 4500 ml.

CONCLUSIONSMost of the massive intraoperative bleeding during pelvic cancer surgery is from the presacral venous plexus and internal iliac vein. The operator should go along with the treatment philosophy to save the life of the patient above all, and to properly perform suture ligation or compression hemostasis according to the actual situation, and with mastered crucial operating hemostatic skills.

Aged ; Blood Loss, Surgical ; Carcinoma, Neuroendocrine ; surgery ; Female ; Hemostasis, Surgical ; methods ; Humans ; Iliac Vein ; surgery ; Ligation ; Male ; Middle Aged ; Neurilemmoma ; surgery ; Pelvic Neoplasms ; surgery ; Pelvis ; blood supply ; surgery ; Rectal Neoplasms ; surgery ; Retrospective Studies ; Suture Techniques ; Veins ; surgery

OBJECTIVETo explore the significance of pelvic hemodynamics as an index in evaluating efficacy of TCM treatment for chronic pelvic inflammation (CPI).

METHODSSixty patients with CPI received treatment with Penyanping, a self-formulated TCM recipe, for 30 days, and the changes of pelvic hemodynamic indexes in them were measured before and after treatment within the 3 - 7 days after menstruation using color Doppler.

RESULTSImprovement of pelvic hemodynamics indexes were shown after treatment in ovarian left arteriopalmus index, bilateral resistance index, maximal speed of left arterial blood flow and score of time-velocity, as compared with those before treatment, the difference was significant respectively (P < 0.05).

CONCLUSIONPelvic hemodynamic indexes could be taken as one of the objective parameters for evaluating efficacy of TCM treatment of CPI according to principle of activating blood circulation to remove stasis, clearing heat and detoxifying.

Adolescent ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hemodynamics ; drug effects ; Humans ; Medicine, Chinese Traditional ; Middle Aged ; Pelvic Inflammatory Disease ; drug therapy ; physiopathology ; Pelvis ; blood supply ; diagnostic imaging ; Phytotherapy ; Time Factors ; Ultrasonography, Doppler, Color

OBJECTIVETo analyze the variability in pelvic artery representation on three-dimensional reconstructed multislice spiral CT images between young adults and the elderly.

METHODSEight young adult volunteers from the medical staff and 8 elderly people undergoing regular coronary artery examination, who were all free of coronary artery disease and diabetes mellitus, were enrolled in this study. After administration of the contrast agent through the median cubital vein at 3.5 ml/s, the subjects underwent contrast-enhanced CT angiography of the pelvic arteries utilizing a 16-row multislice spiral CT. The images were collected and processed with volume reconstruction (VR) technique for three-dimensional reconstruction to distinguish the arteries and their branches.

RESULTSGood visualization of the pelvic artery was observed on the reconstructed CT images of the young subjects, which revealed in detail up to the third- and even the fourth-order vessels, and the arteries were smooth and had plenty of branches; but in the elderly only the second- or third-order vessels were shown, and the arteries appeared stiff with only a few branches.

CONCLUSIONSCompared with the young adults, the elderly have generally poor visualization of the pelvic arteries on three-dimensional reconstructed multislice spiral CT images possibly in association with atherosclerosis and the functional deterioration of the blood vessels in the latter, which is relative to vascular morphologic changes, suggesting the necessity of studying the pelvic vessels with developmental and functional methods.

Adult ; Age Factors ; Aged ; Angiography ; methods ; Arteries ; Arteriosclerosis ; diagnostic imaging ; Contrast Media ; administration & dosage ; Female ; Humans ; Imaging, Three-Dimensional ; methods ; Male ; Middle Aged ; Pelvis ; blood supply ; Tomography, Spiral Computed ; methods