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Review Question - QID 664

In scope icon L 1 A
QID 664 (Type "664" in App Search)
In Figure A, the two red arrows point to which of the following two arteries?
  • A

Superior gluteal and pudendal

2%

25/1526

Internal iliac and medial circumflex

2%

25/1526

External iliac and deep femoral

6%

92/1526

Obturator and external iliac

90%

1369/1526

Medial circumflex and inferior gluteal

0%

7/1526

  • A

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The external iliac and obturator artery anastomose to form the corona mortis. During the Stoppa or ilioinguinal approach to the pelvis, you need to be careful of the corona mortis because the vessels can cause significant bleeding especially if they retract into the pelvis.

In the Tornetta et al article, fifty cadaver halves were dissected to determine the occurrence and location of the corona mortis. Anastomoses between the obturator and external iliac systems occurred in 84% of the specimens. Thirty-four percent had an arterial connection, 70% had a venous connection, and 20% had both. The distance from the symphysis laterally to the anastomotic vessels averaged 6.2 cm.

The Okcu et al article showed similar results in 150 cadavers: they found vascular anastomoses between the obturator and external iliac systems in 61% of the sides, and anastomotic veins in 52% of the exposures. The mean distance between the anastomotic arteries and the symphysis pubis was 6.4 cm, and 5.6 cm for the communicating veins. There seemed to be no significant difference between genders in the incidence of corona mortis and the distance between communicating vessels and the symphysis pubis.

Illustration A is a diagram of the involved vasculature.

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