An Anatomical Cadaveric Study of the Corona mortis: Prevalence, Morphology, and Surgical Implications

ntroduction: Corona mortis is a clinically significant vascular variant in which the obturator artery arises from the external iliac or inferior epigastric system and traverses the superior pubic ramus. Injury to this vessel during inguinal hernia repair or pelvic surgery can result in life-threatening hemorrhage. Enlarged deep inguinal rings may further increase operative risk when aberrant vessels lie in close proximity. Despite its surgical relevance, corona mortis is not routinely evaluated preoperatively.

Cadaver findings: Cadaveric dissection revealed an arterial corona mortis variant in which the obturator artery originated from the external iliac–inferior epigastric system and coursed medial to an enlarged deep inguinal ring. Mesh consistent with prior unilateral hernia repair was identified. Measurements of the artery, deep inguinal ring, and inguinal canal were obtained, with arterial diameter exceeding 2 mm, indicating substantial hemorrhagic potential. Systematic reviews report arterial corona mortis in approximately 26% of hemipelves, and imaging studies demonstrate obturator artery variants in up to 40% of cases. Embryologically, this variation reflects persistence of an anastomotic channel between the external and internal iliac arterial systems.

Conclusion: Corona mortis poses a significant risk of uncontrolled bleeding during pelvic, orthopedic, and laparoscopic hernia procedures. Case reports document pseudoaneurysm formation and delayed postoperative hemorrhage requiring embolization. Preoperative CT angiography may improve surgical planning in selected high-risk cases. This case highlights the importance of recognizing vascular variants in the inguinal and retropubic regions to reduce preventable surgical complications.