Corona mortis

Last revised by Rohit Sharma on 5 Jul 2024

Corona mortis, also known as the crown of death, is a common variant arterial anastomosis between either 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.

In the literature, some authors use 'corona mortis' to refer to two different arterial and venous anastomoses in the pelvis, differentiating between an arterial corona mortis and a venous corona mortis, whereby the latter refers to a venous anastomosis between the obturator vein and either the external iliac vein or inferior epigastric vein 6. This article focuses on the arterial corona mortis.

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.

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.

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.

Cases and figures

  • Case 1
  • Case 2: corona mortis
  • Case 3a: pelvic fracture and hematoma
  • Case 3b: DSA embolization
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