Bilateral absence of ovarian artery in a Tanzanian female cadaver: a

eISSN 1308-4038
International Journal of Anatomical Variations (2012) 5: 73–75
Case Report
Bilateral absence of ovarian artery in a Tanzanian female cadaver: a rare
variation
Published online November 3rd, 2012 © http://www.ijav.org
Germanus Urio KASINDYE
Atuganile Samweli MWASUNGA
Flora M. FABIAN
Department of Anatomy and Histology, International
Medical and Technological University, Dar es Salaam,
TANZANIA.
Germanus U. Kasindye
International Medical and
Technological University
Faculty of Medicine
Department of Anatomy & Histology
P.O. Box 77594
Dar es Salaam, TANZANIA.
+255 713042349
[email protected]
Received August 22nd, 2011; accepted May 30th, 2012
Abstract
During dissection of a 38-year-old female human cadaver at International Medical and
Technological University (IMTU), Department of Anatomy and Histology the anatomical variation
of bilateral absence of ovarian arteries was found. There wasn’t any branch from the abdominal
aorta which supplied the ovaries; instead the ovaries were supplied only by the ovarian branch
of the uterine artery. Arterial variation of the ovarian artery based on origin and course has been
reported previously, but there is no literature which describes bilateral absence of the ovarian
artery. Knowledge of this kind of variation will help the surgeon during surgical procedures to
be carefully in preserving the ovarian branch of uterine artery that is the sole arterial supplier of
the ovaries in the absence of the ovarian arteries.
© Int J Anat Var (IJAV). 2012; 5: 73–75.
Key words [ovary] [bilateral absence of ovarian artery] [uterine artery] [ovarian branch of uterine artery]
Introduction
Ovaries usually are supplied by the gonadal (ovarian) artery
and uterine arteries. The ovarian artery usually originates
from the abdominal aorta below the renal arteries and then
descends to cross the pelvic inlet and supply the ovaries
[1]. They anastomose with terminal branches of the uterine
arteries [2]. On each side, the vessels travel in the suspensory
ligament of the ovary (the infundibulopelvic ligament) as they
cross the pelvic inlet to the ovary. Branches pass through
the mesovarium to reach the ovary to anastomose with the
uterine artery [2]. Early in intrauterine life the ovaries flank
the vertebral column inferior to the kidneys, and so the
ovarian arteries are relatively short, they gradually lengthen
as the ovaries descend into the pelvis [1]. The uterine arteries
are branches of the anterior trunk of the internal iliac artery.
The uterine artery courses medially and anteriorly in the base
of the broad ligament to reach the cervix. Along its course, the
vessel crosses the ureter and passes superiorly to the lateral
vaginal fornix. Once the vessel reaches the cervix, it ascends
along the lateral margin of the uterus to reach the uterine
tube where it curves laterally and anastomoses with the
ovarian artery [2]. It occasionally supplies branches that may
be designated as superior vesical, inferior vesical, ureteral
and vaginal arteries [3]. Anatomical variations of ovarian
artery have been reported by previous authors; however
most of these have shown anatomical variations in the origin
and course of the ovarian arteries [4–7]. There has not been
any report on the bilateral absence of the ovarian artery have
been reported previously. This is therefore considered a rare
case of bilateral absence of ovarian artery.
Case Report
During the anatomical dissection in the Department of
Anatomy of International Medical and Technological University
(IMTU) we observed bilateral absence of ovarian artery in a
38-year-old Tanzanian female human cadaver. In this case
it was observed that in both left and right side there was no
ovarian artery supplying the ovaries (Figure 1). Instead both
the ovaries were found to receive arterial supply from the
ovarian branch of uterine artery (Figure 2). In addition, we
observed that the left uterine artery contributed in the blood
supply to the urinary bladder, while the right uterine artery
didn’t contribute in the blood supply to the urinary bladder
(Figure 2). The contribution of uterine artery to supply the
urinary bladder occasionally occurs and is regarded as a
usual condition.
Kasindye et al.
74
Discussion
LK
RK
AA
IVC
IMA
RU
LOV
ROV
LU
RIIA
OBUA
LIIA
RO
RE
IA IA
ROBUA
RI
The absence of ovarian artery either unilateral or bilateral are
not common and probably have not been reported by previous
authors. Majority of ovarian artery variations that have been
reported include variations in the origin and course [5–8]. In
the present case there is bilateral absence of ovarian artery,
which is extremely uncommon and makes it to be significant
(Figure 1). When the ovaries are supplied only by the ovarian
branch of uterine artery, any vascular occlusion of this
arteries may result in disastrous ischemia of ovaries. Because
the ovaries are supplied by ovarian branch of uterine artery,
the absence of ovarian artery may be undetectable throughout
life of an individual and are usually encountered only during
the surgical procedures, angiographic procedures and during
cadaveric dissections (Figures 1, 2). The knowledge of such
variation has clinical importance especially in the field of
LO
RO
LIIA
LEIA
UTR
LUA
RUBA
RUA
UB
LSVA LUBA
Figure 2. Photograph showing the ovarian branch of right uterine
artery (ROBUA) supplying the ovary. Note that the left uterine artery
(LUA) contribute in the blood supply to the urinary bladder through
superior vesical artery (LSVA). (RIIA: right internal iliac artery; REIA:
right external iliac artery; LIIA: left internal iliac artery; LEIA: left
external iliac artery; RO: right ovary; LO: left ovary; RUA: right uterine
artery; RUBA: right umbilical artery; LUBA: left umbilical artery; UTR:
uterus; UB: urinary bladder)
vascular surgeries and obstetrics and gynecology. Bilateral
absence of ovarian artery may cause the potential hazard
of ovaries encountered in surgical procedures involving the
pelvic organs when the surgeons fails to preserve ovarian
branch of uterine artery. So the surgeon must know and take
into account the possibility that the anatomic variants should
exist as in our case of the bilateral absence of ovarian artery.
We believe that, this case will take its place in the literature
and play a significant role in the surgical intervention in the
abdominal region and also in angiographies. In addition, the
observation of left uterine artery to supply the urinary bladder
through superior vesical artery (Figure 2) it is regarded as a
usual condition, because it occasionally can occur.
Acknowledgement
RUA
UTR
LUA
UB
LSVA
Figure 1. Photograph showing the abdominal aorta (AA) with
bilateral absence of ovarian artery. (RK: right kidney; LK: left kidney;
IMA: inferior mesenteric artery; IVC: inferior vena cava; RU: right
ureter; LU: left ureter; ROV: right ovarian vein; LOV: left ovarian vein;
RO: right ovary; RIIA: right internal iliac artery; LIIA: left internal
iliac artery; RUA: right uterine artery; LUA: left uterine artery; OBUA:
ovarian branch of uterine artery; LSVA: left superior vesical artery;
UTR: uterus; UB: urinary bladder)
We (Germanus and Atuganile) would like to take this
opportunity to acknowledge with thanks to our supervisor
Prof. F. M. Fabian who facilitated a lot in preparation of this
case report. Her support and constructive criticism make us
to ensure that the quality of the case report is maintained.
We wish to pay special tribute to Mr. K. S. Varma, our assistant
supervisor for his great contribution in the image editorial.
We would like to express our sincere thanks to all staff of
Gross Anatomy laboratory of IMTU University, Department
of Anatomy and Histology, for their technical support and
assistance during dissection.
Bilateral absent ovarian artery
75
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