Corona Mortis - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes the anomalous vascular variant - Corona Mortis in the pelvis.

Corona mortis is a popular topic. The corona mortis is a common vascular variant between the external iliac or its branch, which is the inferior epigastric and the obturator.
The obturator artery comes from the internal iliac. The corona mortis is a collateral circulation between the internal iliac and the external iliac.
Please note that the majority of bleeding in pelvic fractures is from the internal iliac artery.
Corona mortis is a connection between the internal iliac branch (obturator) and the external iliac or its branch (the inferior epigastric). Cadaveric studies show that the incidence of the corona mortis is about 84%. However, in clinical practice, the incidence of corona mortis is not that high.
It is present more in females. The venous connection is about 70% and arterial connection is much less. Its location on the superior pubic ramus is variable. It is about 3-7 cm from the symphysis pubis. It is located behind the superior pubic ramus and be careful with lateral dissection of the superior pubic ramus.
The size of this artery is between 2-4 mm and a lot of them are more than 3 mm in size.
It is called the corona mortis because this means the “crown of death”. The corona mortis is susceptible to injury in pelvic trauma and in pelvic surgery. Injury to the corona mortis may lead to significant hemorrhage which may be difficult to control. This hemorrhage presents a challenge to the surgeon and a hazard to the patient during anterior approaches to the pelvis such as with the ilioinguinal approach or intrapelvic approach. Be careful because the retractors may avulse these anomalous vessels.
If you find tis branch, then ligate the vessel to prevent bleeding from this vessel which retracts into the pelvis and is difficult to control because it is located behind the superior pubic ramus in the retropubic area. It will be difficult to reach it and control the bleeding.
The technology of intraoperative ultrasound may improve and may be able to detect this artery during surgery.

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