infundibulopelvic ligament

The infundibulopelvic ligament runs from the ovary to the pelvic sidewall, distinguishing it from the ovarian ligament (proper ligament of the ovary), which connects the ovary to the uterus. The IP ligament carries the ovarian vessels: on the right side, the ovarian artery arises directly from the abdominal aorta (below the renal artery), while the ovarian vein drains into the inferior vena cava; on the left side, the ovarian vein drains into the left renal vein. Clinically, the IP ligament is a major surgical landmark during salpingo-oophorectomy, as the ureter passes in close proximity—crossing under the ovarian vessels near the pelvic brim (the ureter lies just posterior/medial to the IP ligament). This anatomic relationship makes the ureter vulnerable to iatrogenic injury during ligation of the IP ligament, especially in cases of distorted anatomy from endometriosis, malignancy, or prior surgery. Surgeons must identify and skeletonize the ureter before clamping and cutting the IP ligament to prevent ureteral transection or ligation. This ligament is also relevant in ovarian torsion, where twisting of the IP ligament can compromise blood supply to the ovary, leading to ischemia and requiring emergent surgical intervention (detorsion or oophorectomy). Understanding the anatomy of the IP ligament is essential for USMLE questions involving pelvic surgery complications, ovarian blood supply, and the differential diagnosis of pelvic pain (e.g., ovarian torsion vs. ectopic pregnancy vs. appendicitis).