[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Spine](https://durgical.com/en/anatomy/region/spine/) › Internal iliac veins

[Cardiovascular system](https://durgical.com/en/anatomy/system/cardiovascular-system/) · [Spine](https://durgical.com/en/anatomy/region/spine/)

# Internal iliac veins

The internal iliac veins run beside the internal iliac arteries; they drain the pelvic organs and buttocks into the [common iliac veins](https://durgical.com/en/anatomy/common-iliac-vein/).

Official name: Internal iliac vein

[See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=spine&select=internal_iliac_veins&side=r)

Opens in the Durgical app, no sign-up needed.

## What it is

Veins running beside the internal iliac arteries.

## What it does

Drain the pelvic organs and buttocks into the common iliac veins.

## Key points

- Most bleeding in pelvic ring fractures comes from the pelvic venous plexuses and broken bone rather than arteries, which is why the [pelvis](https://durgical.com/en/anatomy/region/pelvis/) is stabilized and packed; embolization treats the arterial part
- Its lateral sacral tributaries connect with the valveless vertebral venous plexus (Batson), a route for [prostate](https://durgical.com/en/anatomy/prostate/) and other pelvic cancers to reach the lumbar [spine](https://durgical.com/en/anatomy/region/spine/) and [sacrum](https://durgical.com/en/anatomy/sacrum/)

## Key facts

**Drains**
Pelvic viscera via venous plexuses (rectal, vesical, uterine, prostatic), gluteal region and perineum; tributaries follow the artery's branches

**Into**
Common iliac vein, in front of the sacroiliac joint

## Relations

**Course**
Forms near the upper edge of the greater sciatic foramen from veins that follow the artery's branches, then climbs behind and slightly medial to the [internal iliac artery](https://durgical.com/en/anatomy/internal-iliac-artery/) to the front of the [sacroiliac joint](https://durgical.com/en/anatomy/sacroiliac-joint/)

**In front**
Internal iliac artery

**Behind**
Lumbosacral trunk and sacroiliac joint

**Lateral**
[Obturator nerve](https://durgical.com/en/anatomy/obturator-nerve/) on the pelvic side wall

**Medial**
[Ureter](https://durgical.com/en/anatomy/ureter/): on the left it runs along the medial side of the vein; on the right the internal iliac artery lies between the ureter in front and the vein behind

## How to find it

It cannot be felt. At surgery it lies behind and slightly medial to the internal iliac artery on the side wall of the pelvis, where it is easily torn when the artery is dissected or tied. On contrast CT it is followed up from the pelvic side wall to its junction with the [external iliac vein](https://durgical.com/en/anatomy/external-iliac-vein/) in front of the sacroiliac joint.

## On imaging

Venous-phase contrast CT or MR venography shows it behind and beside its artery, joining the external iliac vein to form the common iliac vein. In pelvic fractures, CT shows the pelvic haematoma; venous bleeding does not give an arterial blush, which helps decide between packing and embolization. Pelvic congestion is studied with transvaginal Doppler ultrasound, MR venography or venography.

## Clinical notes

- The presacral venous plexus, which drains into it, can bleed heavily in rectal and anterior sacral surgery and is hard to control because the veins retract into the sacrum
- Reflux in its tributaries and in the ovarian veins is associated with pelvic congestion syndrome
- Pelvic vein thrombosis can spread into the common iliac vein and the [inferior vena cava](https://durgical.com/en/anatomy/inferior-vena-cava/)

## Anatomical variants

- It may be double on one or both sides, or join the external iliac vein higher or lower than usual

## Related conditions

- [Haemorrhoids](https://durgical.com/en/conditions/haemorrhoids/)

## Test yourself

Think of the answer, then tap the question to see it.

## Where does most bleeding in pelvic ring fractures come from?

The pelvic venous plexuses draining to the internal iliac veins and broken bone, not arteries; so the pelvis is stabilized and packed.

## Why can presacral venous bleeding draining to the internal iliac vein be hard to control?

The presacral veins retract into the sacrum when cut, in rectal and anterior sacral surgery.

## How do the internal iliac veins offer a route for prostate cancer to the spine?

Their lateral sacral tributaries connect with the valveless vertebral venous plexus (Batson), reaching the lumbar spine and sacrum.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/anatomy/internal-iliac-vein/)

Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
vena iliaca interna TA2 5024

**Official Spanish (DeCS)**
Vena ilíaca interna DeCS D007084

**English (TA2)**
Internal iliac vein

**Also called**
hypogastric vein · vena ilica interna

Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=7267); [Anatomy, Abdomen and Pelvis: Veins](https://www.ncbi.nlm.nih.gov/books/NBK554574/); Tratado de anatomía humana (9.ª ed.), tomo II, Libro IV Angiología, sección 4: Venas (sistemas de las venas cavas superior e inferior, vena porta, venas del raquis).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/anatomy/internal-iliac-vein/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/internal-iliac-vein/