Hip Pelvis.  2019 Mar;31(1):40-47. 10.5371/hp.2019.31.1.40.

The Majority of Corona Mortis Are Small Calibre Venous Blood Vessels: A Cadaveric Study of North Indians

• Kashyap S
• Diwan Y
• Mahajan S
• Diwan D
• Lal M
• Chauhan R

• KMID: 2448040
• DOI: http://doi.org/10.5371/hp.2019.31.1.40

Abstract

PURPOSE
Corona mortis is an abnormal arterial or venous anastomosis between the external iliac and the obturator system of vessels and may cause significant hemorrhage during pelvi-acetabular fracture surgeries, hernia repair and laparoscopic gynecological procedures. Previous studies have estimated a prevalence of corona mortis between 34% and 70%. This cadaveric study was conducted to estimate the prevalence of corona mortis in the North Indian population.
MATERIALS AND METHODS
Twelve cadavers (24 hemipelvises; 11 males and 1 female) with a mean age of 68 (range, 54-82) years were included in this study.
RESULTS
Corona mortis was observed in 14 hemipelvises (58.3%). A total of 19 (79.2%) vascular anastomoses of diameter greater than 1 mm were observed; 5 hemipelvises (20.8%) had corona mortis on the right side, 9 hemipelvises (37.5%) on the left side and bilateral in 5 (41.7%) cases. Two hemipelvises (8.3%) had an arterial connection. An aberrant obturator artery was observed in 1 (4.2%) hemipelvis. A venous connection was found in 14 specimens (58.3% of hemipelvises). The average distance of the connecting vein from the symphysis pubis was 41 (35-70) mm. A vessel diameter of greater than 4 mm was observed in 4/24 (16.7%) of hemipelvises.
CONCLUSION
The frequency of venous corona mortis was higher than arterial corona mortis and the majority (83.3%) were small calibre ( < 4 mm). The presentation pattern and the number of arterial or venous anastomoses were different in the majority of hemipelvises and dissimilar in both hemipelvises of the same cadaver in the majority of cases.

Keyword

Anastomosis; Hemorrhage; Arterial; Venous; Acetabulum

MeSH Terms

Acetabulum
Arteries
Blood Vessels*
Cadaver*
Hemorrhage
Herniorrhaphy
Humans
Male
Prevalence
Pubic Bone
Veins

Figure

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  Fig. 1 One arterial communication between obturator artery and external iliac artery and two venous communications between obturator vein and external iliac vein.

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  Fig. 2 An abnormal (aberrant) obturator artery arising from the inferior epigastric artery. In this case the normal origin of obturator artery from Internal iliac artery was not seen.* Branch to the urinary bladder from the abnormal obturator artery.

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  Fig. 3 A venous communication between obturator vein and external iliac vein.

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