Inferior epigastric vein

At a glance

English

Inferior epigastric vein

Latin (TA2)

Vena epigastrica inferior

System

Vein

Region

Trunk

Side

Paired, left and right

About the inferior epigastric vein

The inferior epigastric vein drains the lower part of the anterior abdominal wall. It is usually a pair of venae comitantes, often uniting into a single trunk near its end, that travel with the inferior epigastric artery. It begins within the rectus sheath, where its branches drain rectus abdominis and the overlying wall, and then runs downwards and laterally. Below the arcuate line it lies between rectus abdominis and the transversalis fascia, and it then curves along the medial side of the deep inguinal ring to open into the external iliac vein just above the inguinal ligament.

Higher up, inside the rectus sheath, its tributaries meet branches of the superior epigastric vein, which comes down from the internal thoracic vein. This connection forms a continuous venous channel in the front wall of the trunk joining the territory of the subclavian veins above with that of the external iliac veins below. When the inferior vena cava is blocked, this route can enlarge and carry blood from the lower body back to the superior vena cava.

The vessels also connect with the paraumbilical veins around the umbilicus, and so with the portal system. In portal hypertension, this link can open up and contribute to the dilated veins seen radiating from the navel.

With its artery, the vein forms the lateral umbilical fold, a ridge on the inner surface of the lower abdominal wall. This fold is the landmark that separates direct inguinal hernias, which push through medial to it, from indirect hernias, which leave through the deep ring lateral to it. Surgeons placing laparoscopic ports, or making incisions near the outer border of rectus, take care to avoid the vessels, since injury causes bleeding into the rectus sheath. The artery and vein together also supply flaps of skin and fat taken from the lower abdomen for reconstructive surgery.

Course and drainage

Begins at

Begins within the rectus sheath from veins of rectus abdominis and the lower anterior abdominal wall, connecting above with the superior epigastric vein.

Drains into

Descends behind rectus abdominis and medial to the deep inguinal ring to open into the external iliac vein just above the inguinal ligament.

Drains

Drains the lower anterior abdominal wall, including rectus abdominis, and provides a link between the external iliac and internal thoracic venous territories.