Abstract
Background: Corona Mortis is an abnormal blood vessels connecting Between obturator and external iliac systems of vessels and inferior epigastric vessels. It is located behind the superior public ramus at a variable distance from the symphysis pubis. Orthopaedic surgeons and obestitrtion found these vessels in the field of surgery. So displaced fractures or iatrogenic injury, can cause life threatening bleeding and hence these vascular anomalies are referred to us crown of death. The bulk of the studies about the corona mortise were conducted in the cadavers or 3D CT angiography and there was no studies were conducted about corona mortise in Sudan. The purpose of this study was to study the corona mortis anatomical and clinical implication in the anterior approaches to the pelvis and acetabulum in Sudanese patient. Methodology: Hospital based descriptive cross-sectional study was conducted among patients sustaining anterior pelvic anterior acetabulum fracture and underwent open reduction internal fixation by reconstruction plates. This study was conducted in Bahri Teaching Hospital from June 2017 to June 2018. Through the most common anterior approaches to the pelvis and acetabulum (Stoppa-modified stoppa-ilioinguinal), done by single surgeon and fulfil data sheet intra-operatively. Results: In a total of 30 pelvic halves corona mortis was detected in 13 patients (43%).The Majority in the Rt.hemipelvies 7 (53.8%) specimens: arterial 4/13 (30.8%), venous 1/13 (7.7%) and both arterial and venous in 8/13 (61.5%) specimens respectively. Of these (53.9%) had a large Diameter > 5 mm and the largest one measure 80 mm, with mean distance From the symphysis 5.8 + 1.6 mm. Conclusion: Only 13 patients have corona mortis, 12 of them were arterial with diameter more than 5 mm (53%), and thus surgeon should exercise caution during Surgery and secure its site to help minimizing surgery time, Clear surgical field and prevent iatrgenic injury.
Highlights
In 2 speciments (2.5%) a large diameter vessels was present (4 or more millimeter). in one case the large diameter vessels was a corona mortise artery running almost vertically behind the superior public ramus connecting the external iliac artery with the obturator artery at 5.2 cm lateral to the symphysis pubis. in the other case the large vessels was an aberrant obturator artery, which originated from the external iliac artery behind the superior public ramus entering the obturator foramen vertically
A vascular connection between the obturator and the external iliac is located over the superior public ramus
A total of 30 pelvic halves corona mortise was detected in 13 patients (43%). the majority in the Rt hemipelvies 7 (53.8%) speciments: arterial 4/13 (30.8%) venous 1/13 (7.7%) and both arterial and venous in 8/13 (61.5%) speciments respectively
Summary
In one case the large diameter vessels was a corona mortise artery running almost vertically behind the superior public ramus connecting the external iliac artery with the obturator artery at 5.2 cm lateral to the symphysis pubis. Corona Mortis is an abnormal blood vessels connecting Between obturator and external iliac systems of vessels and inferior epigastric vessels It is located behind the superior public ramus at a variable distance from the symphysis pubis. Results: In a total of 30 pelvic halves corona mortis was detected in 13 patients (43%).The Majority in the Rt.hemipelvies 7 (53.8%) specimens: arterial 4/13 (30.8%), venous 1/13 (7.7%) and both arterial and venous in 8/13 (61.5%) specimens respectively Of these (53.9%) had a large Diameter > 5 mm and the largest one measure 80 mm, with mean distance From the symphysis 5.8 + 1.6 mm. Conclusion: Only 13 patients have corona mortis, 12 of them were arterial with diameter more than 5 mm (53%), and surgeon should exercise caution during Surgery and secure
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