The Anatomical Characteristics of Corona Mortis: A Systematic Review of the Literature and Its Clinical Importance in Hernia Repair

Abstract

Background: Inguinal hernia repair is one of the most common daily operations in general surgery. However, the anatomical structures of the region, such as the corona mortis (the crown of death), make this procedure quite challenging. A comprehensive knowledge of its anatomy is essential, since massive hemorrhage may occur if the vessel is injured. The current review of the literature aimed to report the frequency and anatomical variations of vascular corona mortis. Methods: A substantial study was coordinated through PubMed, Scopus and Google Scholar. The Prisma guidelines were used for the systematic review of the articles found. A total of 13 studies and 1,455 patients were included for the statistical analysis. Results: The results showed that corona mortis was present in about half the hemi-pelvises, and to be more accurate, the prevalence was 46%. Venous corona mortis was more frequent than the arterial type (42% vs. 25%). Conclusions: Considering the percentages mentioned above, every surgeon who schedules an operation on the retro-pubic area, especially during a hernioplasty procedure, should evaluate the possibility of the presence of corona mortis. Anatomical knowledge of the region is vital for attempting to eliminate the risk of injuring the corona mortis during surgery.

Prevalence and Utilization of Obturator Artery Anatomic Variant in Autologous Breast Reconstruction

“…Classically, CMOR is defined as an arterial anastomosis between the external iliac system and OA (arising from the internal iliac); however, there may also be venous interconnections and/or replaced OA (arising from either the external iliac or inferior epigastric, as in our study). Two recent meta-analyses have reported prevalence of the corona mortis to be 46 and 49.3%, respectively, 22,27 with arterial CMOR at 25% in the Noussios et al's study and 17% in the Sanna et al's study. Notably, most of the included studies in the meta-analyses were based on cadaver dissections, which may limit findings due to vascular disease or prior surgery.…”

Combined Anterior Pelvic (CAP) approach for fracture acetabulum fixation - Functional outcome evaluation and predictors of outcome

“…A recent systematic review of literature has reported the prevalence up to 46%. 39 This anastamosis is encountered during intra-pelvic approaches to acetabulum and may causes serious bleeding if injured. In current study no patient encountered corona mortis injury.…”

Corona Mortis: A Systematic Review of Literature

“…The topic has already been addressed in different types of studies such as bibliographic reviews ( 8 , 9 ), case reports, cadaver dissections, studies based on image examination ( 10 - 12 ), and surgeries ( 13 , 14 ). There is a lack of consensus regarding some aspects of CM , resulting from contradictory data among different studies.…”