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Topic

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Obturator artery

The obturator artery is a branch of the anterior division of the internal iliac artery, usually arising close to the origin of the umbilical artery. It courses anteroinferiorly along the pelvic wall, running on the lateral pelvic brim, and accompanies the obturator nerve and vein toward the obturator canal. It exits the pelvis through the canal to reach the medial thigh, where it anastomoses with the medial circumflex femoral artery and inferior epigastric artery.

The artery plays a key role in vascularizing the pelvic wall, obturator muscles, medial thigh muscles, femoral head (via acetabular branch), and hip joint.

Course

  1. Origin: Most commonly from anterior division of internal iliac artery.

  2. Pelvic course: Runs along lateral pelvic wall, between external iliac vessels and pelvic sidewall.

  3. Obturator canal: Travels with obturator nerve and vein, exits pelvis into medial thigh.

  4. Thigh course: Supplies adductor region and anastomoses with profunda femoris branches.

Branches

  • Anterior branch: Supplies obturator externus, pectineus, adductors, gracilis; gives cutaneous branch to medial thigh.

  • Posterior branch: Supplies adductor magnus, obturator externus; gives acetabular branch through acetabular notch to femoral head.

  • Acetabular branch: Small but clinically critical; passes via ligamentum teres to supply femoral head (especially important in children).

Variants

  • Accessory obturator artery: Arises from inferior epigastric or external iliac artery (~20–30%).

  • Corona mortis (arterial type): Anastomosis between obturator artery (or accessory obturator artery) and inferior epigastric artery across the pubic bone — important surgical risk.

  • Origin variants: Can arise from inferior epigastric (most common), external iliac, or posterior division of internal iliac.

Synonyms

  • Arteria obturatoria

  • Pelvic obturator branch

Function

  • Supplies blood to pelvic muscles, medial thigh muscles, hip joint, and femoral head

  • Provides collateral circulation between internal and external iliac systems

  • Clinical importance in hip pathology, pelvic fractures, trauma, and reconstructive surgery

MRI Appearance

T1-weighted images:

  • Appears as a small linear hypointense flow void against bright pelvic fat.

  • Visualized running along pelvic sidewall and into obturator canal.

T2-weighted images:

  • Normal flow: signal void.

  • Aneurysm or thrombus: lumen may appear heterogeneous or hyperintense.

STIR:

  • Suppresses pelvic fat, improving visibility of vascular structures.

  • Perivascular edema, hematoma, or inflammation appears hyperintense.

T1 Fat-Suppressed Post-Gadolinium:

  • Artery enhances brightly and homogeneously, allowing tracing from pelvic origin to obturator canal.

  • Highlights vascular malformations, encasement by tumor, or corona mortis anastomosis.

MRA Pelvis with Gadolinium:

  • Excellent for mapping obturator artery and its branches.

  • Identifies origin, course, variants, and corona mortis.

  • Used in preoperative planning for pelvic oncology, trauma embolization, or hernia rep

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