Deep Epigastric Artery 371 



may also anastomose with the lumbar and intercostal arteries. The 

 vas deferens bends round the epigastric artery to reach the base of 

 the bladder. 



Branches of the deep epigastric. The pubic descends to the back 

 of the pubes, where it may anastomose with the branch of the opposite 

 side and with the pubic branch of the obturator (p. 306). In every three 

 or four subjects the latter anastomotic loop is of great size, and gives off 

 the obturator artery itself. The branch thus coining from the epigastric 



Irregular obturator from deep epigastric, taking, A, safe course, close to vein and on outer side 

 of femoral ring, and, u, taking dangerous course on inner side of femoral ring. (GRAY.) 



is called the irregular obturator artery, which generally dips down close 

 on the inner side of the iliac vein, so that the neck of a femoral hernia 

 would lie between it and Gimbernat's ligament, as shown herewith. 

 But now and then the hernia slips down between the irregular artery 

 and the external iliac vein, so that when the surgeon cuts upwards 

 and inwards to ease the strangulation, haemorrhage is unavoidable. 

 Before making that incision he could rarely inform himself of the pre- 

 sence of the vessel, but on the occurrence of the bleeding he would 

 quickly reduce the hernia, put his finger through the now empty crural 

 ring, and tiy to seize the vessel with catch-forceps ; or he might care- 

 fully dilate the opening and try to hook down the wounded artery. 

 He could not enlarge the wound by cutting, because of the important 

 surroundings. 



The creniasteric branch supplies the coverings of the cord and 

 may anastomose with twigs of the spermatic, with the artery of the 

 vas, or with a branch of the common femoral. 



The deep circumflex iliac arises near the deep epigastric and is 

 similarly placed between peritoneum and transversalis fascia ; running 

 outwards, it lies in the crevice between the iliac and transversalis fasciae 

 as they are attached along the outer part of Poupart's ligament (p. 1 56). 

 It then passes through the transversalis fascia and muscle to lie near 

 the iliac crest in the connective tissue between the internal oblique and 

 transversalis. It anastomoses with lumbar and lower intercostal 

 arteries ; with the iliac branch of the ilio-lumbar, and, over the iliac 

 crest, with the glutcal ; possibly also with the ascending branches 

 of the external circumflex. 



B 13 2 



