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

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Purpose:The obturator artery and its accessory (aberrant) arising from different origins and crossing the pubic rami are vascular variations.The intal iliac artery usually provides the obturator artery which may communicates with the extal iliac artery through either the accessory obturator or inferior epigastric artery.A collateral circulation between the extal and intal 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 extal 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 extal and intal iliac system referred as corona mortis is addressed.This study includes new classification of obturator and accessory obturator arteries as well as the corona morris.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 intal fixation of pubic fracture,an inguinal hia repair.Further,traumatic pubic rami fracture may lead to massive hemorrhage due to laceration of the obturator artery.
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