Corona mortis
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At the time the article was created Charlie Chia-Tsong Hsu had no recorded disclosures.
View Charlie Chia-Tsong Hsu's current disclosuresAt the time the article was last revised Patrick O'Shea had no financial relationships to ineligible companies to disclose.
View Patrick O'Shea's current disclosures- crown of death
The crown of death (Latin: corona mortis), is a common variant arterial anastomosis between the external iliac artery or deep inferior epigastric artery and the obturator artery. Injury to this anastomosis (e.g. due to pubic ramus fractures) may cause significant hemorrhage.
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Epidemiology
The corona mortis is reported to be present in 33% of patients on routine multidetector CT examination 1,4. One study of 100 patients found the variant to be more common in females and more commonly unilateral than bilateral (2:1) 5.
Radiographic features
The anastomosing vessel is reported to be found ~50 mm (range: 35-72 mm) from the pubic symphysis 5. The vessel itself ranges in diameter from 1.4-3.7 mm and may be occluded in patients with peripheral vascular disease 5.
Clinical importance
Knowledge of this variant arterial anastomosis is critical for surgical planning and in pelvic trauma, as it is highly susceptible to injury given its posterior relation to the superior pubic rami 2.
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See also
References
- 1. Smith JC, Gregorius JC, Breazeale BH et-al. The corona mortis, a frequent vascular variant susceptible to blunt pelvic trauma: identification at routine multidetector CT. J Vasc Interv Radiol. 2009;20 (4): 455-60. doi:10.1016/j.jvir.2009.01.007 - Pubmed citation
- 2. Darmanis S, Lewis A, Mansoor A et-al. Corona mortis: an anatomical study with clinical implications in approaches to the pelvis and acetabulum. Clin Anat. 2007;20 (4): 433-9. doi:10.1002/ca.20390 - Pubmed citation
- 3. Pua U, Teo LT. Prospective diagnosis of corona mortis hemorrhage in pelvic trauma. J Vasc Interv Radiol. 2012;23 (4): 571-3. doi:10.1016/j.jvir.2011.12.018 - Pubmed citation
- 4. Berberoğlu M, Uz A, Ozmen MM et-al. Corona mortis: an anatomic study in seven cadavers and an endoscopic study in 28 patients. Surg Endosc. 2001;15 (1): 72-5. Pubmed citation
- 5. Steinberg EL, Ben-Tov T, Aviram G, Steinberg Y, Rath E, Rosen G. Corona mortis anastomosis: a three-dimensional computerized tomographic angiographic study. Emergency radiology. doi:10.1007/s10140-017-1502-x - Pubmed
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