Vascular anatomy over the superior pubic rami in female cadavers

The Corona Mortis, a Frequent Vascular Variant Susceptible to Blunt Pelvic Trauma: Identification at Routine Multidetector CT

“…There is, however, no consensus that the corona mortis is limited to only a replaced obturator artery originating from the external iliac artery system. Anatomically, this variant has also been described as representing either venous or arterial communication between the external iliac system and the obturator vessels that originate from or drain into the internal iliac artery or vein, respectively (15,(17)(18)(19). In addition, the venous variation has been reported to be higher in both prevalence and prominence than its arterial correlate (8,10,18).…”

“…In anatomic studies, the prevalence of the corona mortis (per hemipelvic side) has been reported as 1%-43% in cadaver studies (7,9,10,12,14,15,19,20,22), 29% in a reported angiographic study (5), and 10%-22% in several endoscopic studies (6,17). Of note, the wide range of reported prevalences of the corona mortis may be related to the discretion of the authors at inclusion/exclusion diameter criteria, with ranges including "macroscopically seen;" less than 1 mm, more than 1 mm, and more than 2 mm in diameter; and as no reported size criteria (5,7,17,19,22). Significantly, most of the identified corona morti in our study were between 2.0 and 3.0 mm.…”

Demonstration of pelvic anatomy by modified midline transection that maintains intact internal pelvic organs

“…The pelvic course of the obturator nerve and accompanying blood vessels was clearly visible and in some cases revealed variant arrangements of the vessels over the superior pubic ramus. The most common variation was the presence of accessory or aberrant obturator vessels, which are either arterial or venous anastomoses between the inferior epigastric and obturator vessels (Okcu et al, 2004; Drewes et al, 2005), known as “corona mortis” (Fig. 5).…”

Site-specific prolapse surgery. I. Reliability and durability of native tissue paravaginal repair

“…First priority upon entering the paravesical space was to carefully examine the area near the superior pubic ramus, to look for accessory obturator vessels. Laceration of a high volume collateral circulation between the internal (via the main obturator vessels) and external iliac systems (via the inferior epigastrics) can produce catastrophic bleeding [9, 10]. Because aberrant obturator vessels seldom course anterior to the obturator notch, dissection to search for paravaginal defects was begun near the symphasis pubis.…”