Corona mortis: incidence and location

Abstract

The right hemipelvis of 98 patients was examined by angiography to determine the occurrence and location of the corona mortis artery. This arterial anastomosis was found in 28.5% (28 of 98). Its incidence was 30.5% (18 of 59) in men and 25.6% (10 of 39) in women; this difference was not significant ( p>0.05). The distance from the symphysis pubis to the anastomotic artery averaged 33.4 mm (range 21.4-41 mm). It was 31.8 mm (range 21.4-39.3 mm) in men and 36.2 mm (range 25-41 mm) in women; this difference was significant ( p<0.05).

Bilateral variation of the venous corona mortis with a presentation previously undescribed

“…In the case of arteries, this distance is even greater [13]. This anatomical variation is probably more relevant in traumatology, involving fractures of the pubis, where not only may the fracture act as a risk factor for bleeding, but the osteosynthesis material located in this region must also take this variation into consideration [3,6,7]. The same is true for gastric surgeons involved in inguinal hernias, which may be located precisely in this variation, increasing the risk of bleeding [9].…”

“…Of these origins, the first one is the most common, followed by the arterial and venous origin, with the arterial origin being the least common [1]. The incidents described have a wide variability, showing 20-80% for venous and 14-28% for arterial anastomosis [1,2,[4][5][6][8][9][10][11][12][13][14][15]. Apparently, there is no significant difference in the incidence between men and women, nor in the distance between the involved vessels and the symphysis pubis [11].…”

Corona Mortis: Importancia Anatomo ­ Clínica y Ocurrencia en una Muestra de la Población Colombiana

“…Este evento y la posterior retracción de los vasos hacia la cavidad pélvica, pueden ocurrir en fracturas del pubis o durante intervenciones quirúrgicas que involucran la parte inferior de la pared abdominal anterior, tales como herniorrafias inguinales y femorales, cistectomías radicales, accesos anteriores al acetábulo como el ilioinguinal o el intrapélvico, procedimientos para el tratamiento de la incontinencia urinaria de esfuerzo como la TVT Secur y otras maniobras quirúrgicas que involucran la región retropúbica (Darmanis et al;Mahato;Stavropoulou-Deli & Anagnostopoulou;Smith et al;Karakurt et al, 2002;Sarikcioglu & Sindel, 2002). No obstante, la ventaja que ofrecen estas anastomosis es que se puede contar con una vía de circulación colateral cuando se presentan algunos tipos de obstrucción aortoiliaca (Jaburek et al, 2011).…”

Corona Mortis : anatomical and surgical description on 60 cadaveric hemipelvises

“…This anatomical variant is of clinical and surgical interest, as it is susceptible to iatrogenic lesions during hernia repairs, gynecological and orthopedic procedures, and may also be damaged in fractures of the pubis or acetabulum. The literature also reports the difficulty in performing CM hemostasis and the fact that this anatomical variation determines collateral circulation between EIA and the IIA [5][6][7][8][9][10] .…”

“…Corona mortis (CM), or death crown, is defined as an arterial or venous connection between the anastomotic branches of the obturator artery and the inferior epigastric artery over the superior branch of the pubis [5][6][7][8][9] . This anatomical variant is of clinical and surgical interest, as it is susceptible to iatrogenic lesions during hernia repairs, gynecological and orthopedic procedures, and may also be damaged in fractures of the pubis or acetabulum.…”