A Very Low-Positioned Aortic Bifurcation

Jad A Degheili 1, Haya Malhas 2, Tag Keun Yoo 3, Mohamad Yasser R Dergham 4

Affiliations

doi: 10.5758/vsi.200009

Abstract

Anomalies of the aortoiliac arteries are rarely reported and are generally discovered incidentally on imaging performed mostly for investigation of other medical concerns. While aortic bifurcation is typically reported at the fourth lumbar vertebra, variations are possible. We present a case with very low aortic bifurcation, almost at the level of S2, with various other anomalies including a corkscrew left common iliac artery passing just anterior to the bladder dome with pulsation noted during cystoscopy. An ectopic right kidney was also noted. To our knowledge, these vascular anomalies have not been reported previously.

Keywords: Anatomy; Aortic bifurcation; Computed tomography; Lumbosacral spine; Sacrum.

Conflict of interest statement

CONFLICTS OF INTEREST

The authors have nothing to disclose.

Figures

Fig. 1 Sagittal cross-section of an enhanced computed tomography scan during the arterial phase, showing aortic bifurcation at approximately the S2 level (arrow).

Fig. 1 Sagittal cross-section of an enhanced computed tomography scan during the arterial phase, showing aortic bifurcation at approximately the S2 level (arrow).

Fig. 2 Coronal cross-section of an enhanced computed tomography scan showing the left common iliac artery coursing in a corkscrew pattern, just anterior to the bladder dome (arrow). Also noted are the bilateral common femoral arteries (arrowheads).

Fig. 2 Coronal cross-section of an enhanced computed tomography scan showing the left common iliac artery coursing in a corkscrew pattern, just anterior to the bladder dome (arrow). Also noted are the bilateral common femoral arteries (arrowheads).

Fig. 3 Three-dimensional reconstructed image of a computed tomography scan showing the course of the left common iliac artery (arrow) anterior to the bladder dome (asterisk).

Fig. 3 Three-dimensional reconstructed image of a computed tomography scan showing the course of the left common iliac artery (arrow) anterior to the bladder dome (asterisk).

Fig. 4 Three-dimensional reconstructed image, excluding the bladder, showing various vascular anomalies, including a deviated abdominal aorta to the right side with a very low bifurcation level at the sacrum; the left external iliac artery arises at the upper level of the femoral head (arrow), giving rise to the common femoral artery just below the inguinal ligament (arrowhead).

Fig. 4 Three-dimensional reconstructed image, excluding the bladder, showing various vascular anomalies, including a deviated abdominal aorta to the right side with a very low bifurcation level at the sacrum; the left external iliac artery arises at the upper level of the femoral head (arrow), giving rise to the common femoral artery just below the inguinal ligament (arrowhead).

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