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KMID : 0358419690120090017
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Korean Journal of Obstetrics and Gynecology
1969 Volume.12 No. 9 p.17 ~ p.22
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Ligation of the Internal Iliac Artery (Hyogastric)
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吳聖奎/Oh, S.K
郭顯模/李然熙/李瑢培/Kwak, H.M/Lee, Y.H:Lee, Y.B/Yang, Y.H
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Abstract
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Hemorrhage is still one of the most important cause of maternal mortality and also in Gynecological field, we meet occasionally profuse hemorrhage which is difficult or impossible to control by, the conventional methods of packing or suturing, or both. In such situation that multiple transfusion, plasma and packing with suturing ;failed to control bleeding, we must decide some definite procedure before patient drops in shock and in death. This report deals with our experiences on several cases of Internal lliac Ligation permanently or temporally and reported two cases, one case is trophoblastic tumor possibly degenerated choriocarcinonia of the uterus and the other is advanced carcinoma of the cervix. In both cases,we got excellent result and bleeding stopped immediately and could save them.
We reviewed several articles concerning ligations of the Internal Iliac Artery and summarize anatomical relationship about surgical anatomic character of vesseles involved. There is enough and adequate collateral circulation in the pelvic organs and even after both bilateral Internal Iliac artery and ovarian artery ligation, there is no artery evidence of ill effects upon the pelvic viscera including the bladder and the bowel.
Interesting study about the hemodynamics of ligation of Internal Iliac artery by Dr. Clay . Burchell reported only unilateral ligation decreased pulse pressure significantly and show adequate result.
In the past time ligation of the Internal Iliac artery was performed in the case of Gynecological malignancy such as cervical cancer and uterine cancer but recently it is used in nonmalignant cases such as postpartumhemorrhage or vault bleeding after hysterectomy ect. All Obstetrician, Gynecologist and general Surgeon who do pelvic operation should familiar with this life-saving procedure and do this operation for the patient who need it without delay or waiting, because it may cost the patient her life.
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