Corona mortis

Last revised by Patrick O'Shea on 14 May 2024

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.

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.

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