A patient with tense ascites due to cirrhosis is posted for diagnostic paracentesis at a left lower quadrant site. When selecting the puncture point in either lower quadrant, the operator must specifically avoid injuring which vessel that runs a vertical course on the deep surface of the anterior abdominal wall?

• A Superficial epigastric artery
• B Deep circumflex iliac artery
• C Inferior epigastric artery ✓
• D External iliac artery

Explanation

The inferior epigastric artery arises from the external iliac artery just above the inguinal ligament and ascends on the posterior surface of rectus abdominis along the lateral border of Hesselbach's triangle. A paracentesis needle placed too far medially in the lower quadrant can lacerate it and cause a rectus sheath haematoma, so the standard site is kept lateral, about 2 cm above and medial to the anterior superior iliac spine. The superficial epigastric artery lies in Camper's fascia and causes less serious bleeding.

Reference: Moore's Clinically Oriented Anatomy, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.