Inferior epigastric artery

The inferior epigastric artery arises from the external iliac artery, immediately above the inguinal ligament. It curves forward in the subperitoneal tissue, and then ascends obliquely along the medial margin of the abdominal inguinal ring; continuing its course upward, it pierces the transversalis fascia, and, passing in front of the linea semicircularis, ascends between the Rectus abdominis and the posterior lamella of its sheath. It finally divides into numerous branches, which anastomose, above the umbilicus, with the superior epigastric branch of the internal thoracic artery and with the lower intercostal arteries.

As the inferior epigastric artery passes obliquely upward from its origin it lies along the lower and medial margins of the abdominal inguinal ring, and behind the commencement of the spermatic cord. The ductus deferens, as it leaves the spermatic cord in the male, and the round ligament of the uterus in the female, winds around the lateral and posterior aspects of the artery.  

The branches of the inferior epigastric artery are:

• The cremasteric artery (external spermatic artery) in male, which accompanies the spermatic cord, and supplies the Cremaster and other coverings of the cord, anastomosing with the internal spermatic artery

• The artery of round ligament of uterus in the female, that is very small and accompanies the round ligament.

• The pubic branch of inferior epigastric artery which runs along the inguinal ligament, and then descends along the medial margin of the femoral ring to the back of the pubis, and there anastomoses with the pubic branch of the obturator artery, giving the accessory obturator artery

• Some muscular branches, that are distributed to the abdominal muscles and peritoneum, anastomosing with the iliac circumflex and lumbar arteries; branches which perforate the tendon of the Obliquus externus, and supply the integument, anastomosing with branches of the superficial epigastric.  

Peculiarities.—The origin of the inferior epigastric may take place from any part of the external iliac between the inguinal ligament and a point 6 cm. above it; or it may arise below this ligament, from the femoral. It frequently springs from the external iliac, by a common trunk with the obturator. Sometimes it arises from the obturator, the latter vessel being furnished by the hypogastric, or it may be formed of two branches, one derived from the external iliac, the other from the hypogastric.