Terminal aortic quadrifurcation: A rare congenital anomaly

Abstract

Background: Anomalous termination of the abdominal aorta is exceptionally rare. Although the prevalence is unknown, the knowledge of this variation and its association with surrounding structures becomes particularly relevant in vascular relationships to organ resections, laparoscopic surgeries, interventional radiologic procedures and pelvic organ transplants. Methods: During routine dissection for medical students, an adult male cadaver was dissected following the Cunningham's manual for dissection. Results: There was an unusual division of the distal abdominal aorta. Opposite the body of the 4th lumbar vertebra, the abdominal aorta divided into four branches (a left and right external and internal iliac artery) manifesting absence of the common iliac arteries. However, the accompanying venous architecture was normal. Conclusion: To our knowledge, only two of similar findings have been reported in literature. Acquaintance with this variation will help to ensure understanding and accurate interpretation of radiological images, and serve as a guide to circumvent difficulties during abdominal and pelvic procedures.

Keywords

• Terminal abdominal aorta
• Quadrifurcation
• Rare anomaly