The inferior epigastric artery and its accompanying veins arise from the terminal portion of the external iliac vessels between transversalis fascia and parietal peritoneum (see TRAM flap folios, VID 183 and VID 184.) The vessels run diagonally upward toward the back of the lower third of the rectus muscle.
Go back to the CT animation in frame 2 and use the cursor to selectively animate the lower abdominal wall. The course of the epigastrics on both sides can be followed. The hematoma was presumed to be due to injury to the left inferior epigastric artery by the needle. The patientís hematocrit dropped from 35 to 20 and stabilized, as did the size of the hematoma. Interventional radiology was not required to embolize the vessel and control further bleeding.
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