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Corona Mortis

ramus anastomoticus pubicus (corona mortis)

The corona mortis (Latin for crown of death) is an anastomosis between the obturator vessels and the external iliac or inferior epigastric vessels, crossing the back of the superior pubic ramus. It may be an artery, a vein or both, and venous connections are the most common. It is present in a large proportion of people, and in some it replaces the normal obturator artery origin.

Anatomical Data

Course & Branches

Origin	Inferior epigastric or external iliac artery or vein
Course	Descends over the back of the superior pubic ramus, close to the lacunar ligament, to join the obturator vessels at the obturator canal
Branches	Pubic branches to the back of the pubis Connection with the obturator artery or vein

Clinical Relevance

Clinical Notes

Because it lies directly on the superior pubic ramus, the corona mortis is at risk in anterior approaches to pelvic and acetabular fractures (such as the Stoppa and ilioinguinal approaches), in laparoscopic inguinal and femoral hernia repair, and in pelvic fractures themselves. If cut, the vessel can retract into the obturator canal and bleed briskly, which gave it its name. Surgeons identify and tie it before working on the pubic ramus.

Pathology

Common Injuries & Conditions

Haemorrhage in Pelvic Surgery

Unrecognised division of the corona mortis during pelvic fracture fixation or hernia repair causes bleeding that is difficult to control as the cut end retracts into the obturator canal.

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