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. 2016 Oct 1;19(5):251-254.
doi: 10.1016/j.cjtee.2016.06.004.

A new concept and classification of corona mortis and its clinical significance

Waseem Al Talalwah  1
Affiliations

A new concept and classification of corona mortis and its clinical significance

Waseem Al Talalwah. Chin J Traumatol. .

Abstract

Purpose: The obturator artery and its accessory (aberrant) arising from different origins and crossing the pubic rami are vascular variations. The internal iliac artery usually provides the obturator artery which may communicates with the external iliac artery through either the accessory obturator or inferior epigastric artery. A collateral circulation between the external and internal iliac system is known as corona mortis. The aim of current study is to provide sufficient data of vascular variability crossing the pubic rami for clinical field.

Methods: Present study includes 208 hemipelvises dissected in the Institution of Anatomy, Medical University of Graz. During dissection, the obturator artery and its accessory crossing the superior rami of pubic bone were found to have different origins.

Results: The obturator artery arising from the external iliac artery and from the femoral artery accounts for 9.8% and 1.1% respectively. Therefore, it passes over the superior pubic rami in 10.9%. Further, the accessory (aberrant) artery arises only from the femoral artery in 1.1%. In present study, the vascular variation crossing the superior pubic rami with or without collateral circulation between external and internal iliac system referred as corona mortis is addressed. This study includes new classification of obturator and accessory obturator arteries as well as the corona mortis. It includes a comparison of corona mortis incidence in Austria population and other populations. The corona mortis found to be in 12% of Austrian population.

Conclusion: A great attention of clinicians, radiologists, surgeons, orthopedic surgeons, obstetricians and gynecologists has to be considered before pubic surgical procedures such as internal fixation of pubic fracture, an inguinal hernia repair. Further, traumatic pubic rami fracture may lead to massive hemor- rhage due to laceration of the obturator artery.

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Figures

Fig. 1
Fig. 1
The obturator artery arising from the anterior trunk of the internal iliac artery. CIA: common iliac artery; EIA: external iliac artery; IIA: internal iliac artery; IEA: inferior epigastric artery; OA: obturator artery.
Fig. 2
Fig. 2
The obturator artery arising directly from the external iliac artery. EIA: external iliac artery; IIA: internal iliac artery; IEA: inferior epigastric artery; OA: obturator artery.
Fig. 3
Fig. 3
The obturator artery arising indirectly from the external iliac artery, that is, from a common trunk with the inferior epigastric artery. EIA: external iliac artery; IIA: internal iliac artery; CT: common trunk; IEA: inferior epigastric artery; OA: obturator artery.
Fig. 4
Fig. 4
The obturator artery arising from the internal iliac artery anastomosing with the accessory obturator artery arising from the external iliac artery known as arterial corona mortis. CIA: common iliac artery; EIA: external iliac artery; IIA: internal iliac artery; IEA: inferior epigastric artery; OA: obturator artery. ON: obturator nerve; AOA: accessory obturator artery; SGA: superior gluteal artery; IPA: internal pudendal artery; PSA: persistent sciatic artery.
See this image and copyright information in PMC

References

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