Inferior epigastric nodes

At a glance

English

Inferior epigastric nodes

Latin (TA2)

Nodi epigastrici inferiores

System

Lymphatic

Region

Trunk

Side

Paired, left and right

About the inferior epigastric nodes

The inferior epigastric nodes are a small group of parietal nodes, usually three or four, lying along the inferior epigastric artery and vein. These vessels arise from the external iliac vessels just above the inguinal ligament, run up and medially on the inner side of the anterior abdominal wall, and enter the rectus sheath behind rectus abdominis. The nodes are scattered along their course, between the muscle and the peritoneum.

Near their starting point the vessels pass along the medial side of the deep inguinal ring, so the lowest nodes lie close to the inner opening of the inguinal canal. Higher up, the vessels raise a ridge of peritoneum, the lateral umbilical fold, seen from inside the abdomen. Above the umbilicus the inferior epigastric vessels link with the superior epigastric vessels from the chest.

These nodes collect lymph from the deep tissues of the lower anterior abdominal wall below the umbilicus: the rectus abdominis and the other abdominal muscles, and the parietal peritoneum lining them. Their outflow runs down along the vessels to the external iliac nodes beside the external iliac artery and vein.

The nodes are rarely seen in health. They may be involved when a tumour spreads within the abdominal wall, or when cancer cells seed into the peritoneum of the lower abdomen. Their path is also of interest because the deep lymph of the lower abdominal wall goes to the pelvis rather than to the groin, unlike the lymph from the overlying skin.

Course and drainage

Begins at

Afferent vessels from the deep tissues of the anterior abdominal wall below the umbilicus, including rectus abdominis and the parietal peritoneum.

Drains into

Efferent vessels pass down along the inferior epigastric vessels to the external iliac nodes.

Drains

Filters deep lymph from the lower anterior abdominal wall. Rarely significant, but a route for spread of tumours within the wall or lower peritoneum to the pelvic nodes.