Corona mortis, aberrant obturator vessels, accessory obturator vessels: clinical applications in gynaecology

Abstract

Corona mortis (CMOR) is a heterogeneous and often dubious term that causes much confusion in medical literature, especially in regard to its modern day significance in pelvic surgery. Some authors define CMOR as any abnormal anastomotic vessel between the external iliac and obturator vessels, whereas others define it as any vessel coursing over the superior pubic branch, regardless whether it is a vascular anastomosis, an accessory obturator vessels, an obturator vessel related to the external iliac system or a terminal small vessel. There is no standard classification of CMOR and obturator vessels variations, although there are multitudes of classifications describing the diverse variations in the obturator foramen region. We define accessory obturator, aberrant obturator vessels and CMOR as different structures, as CMOR is an anatomical term that reflects a clinical situation rather than an anatomical structure. A new clinical classification for aberrant, accessory obturator vessels and CMOR is proposed regarding the anatomical variations, and the location of vessels to the deep femoral ring. The clinical significance of accessory obturator, aberrant vessels and CMOR is delineated in oncogynaecological and urogynaecological surgery.