A South Indian cadaveric study on obturator neurovascular bundle with a special emphasis on high prevalence of ‘venous corona mortis’ |
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| Institution: | 1. Service d’Anesthésie-Réanimation, Hôpital Européen Georges Pompidou, Université Paris 5 Descartes, Sorbonne Paris Cite, Paris, France;2. Department of Anesthesia and Perioperative Care, San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, USA;3. Département de Biostatistique et Informatique Médicale, INSERM U1153, équipe ECSTRA, Hôpital Saint Louis, Université Paris Diderot, Sorbonne Paris Cite, Paris, France;4. SAMU 92, Hôpital Raymond Poincare, Université de Versailles St Quentin, Garches, France;5. Division of Biostatistics, School of Public Health, University of California Berkeley, Berkeley, USA;1. KU Leuven – University of Leuven, Faculty of Medicine, B-3000 Leuven, Belgium;2. University Hospitals Leuven, Department of Trauma Surgery, B-3000 Leuven, Belgium;3. University Hospitals Leuven, Care Program Management, B-3000 Leuven, Belgium;4. KU Leuven – University of Leuven, Department of Development and Regeneration, B-3000 Leuven, Belgium;1. The Orthopaedic Trauma Unit, Division of Orthopaedics, University of Alabama at Birmingham, United States;2. Talpiot Medical Leadership Program, Sheba Medical Centre, Israel;1. Department of Orthopaedic Surgery, Oslo University Hospital, Ullevaal, Oslo, Norway;2. Department of Orthopaedic Surgery, Akershus University Hospital, Lørenskog, Norway;3. Department of Orthopaedic Surgery, Karolinska University Hospital, Stockholm, Sweden;4. Department of Spinal Cord Injury and Multitrauma Unit, Sunnaas Hospital, Nesodden, Norway;5. Department of Radiology, Oslo University Hospital, Ullevaal, Oslo, Norway;6. Faculty of Medicine, University of Oslo, Norway;7. Division of Surgery and Clinical Neuroscience, Oslo University Hospital, Oslo, Norway;1. Department of Orthopedic Surgery, College of Medicine, Inje University, Busan Paik Hospital, 75, Bokji-ro, Busanjin-gu, Busan 47392, Republic of Korea;2. Department of Orthopedic Surgery, College of Medicine, Dong-A University, 26, Daesingongwon-ro, Seo-gu, Busan 49201, Republic of Korea |
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| Abstract: | Surgical procedures in the pelvic region are very challenging because of the complex anatomy of this region. “Corona mortis” is a term used to describe retro-pubic anastomosis between the obturator and external iliac vessels. It is considered as a key structure as significant haemorrhage may occur if the vessels are cut accidentally during pelvic surgeries. Earlier studies have documented a high frequency of venous anastomosis compared to its arterial counterpart. The objective of our study was to document the prevalence of venous corona mortis in South Indian human adult cadaveric pelvises. We conducted this study on 73 cadaveric pelvic halves. Out of the 73 hemi pelvises, 36 were normal without any variations of the obturator vessels while 37 hemi pelvises (51%) showed the presence of abnormal obturator vessels which proves to be a very high incidence in terms of variations. Out of the 37 hemi pelvises, 25 (68%) showed the presence of 2 obturator veins, out of which 1 was normal and the other was an abnormal obturator vein. 8 hemi pelvises (22%) had only abnormal obturator vein. Most of the abnormal obturator veins drained into the external iliac vein, while two veins drained into inferior epigastric veins. Venous corona mortis is said to be frequently encountered during surgery and is considered to be as important as arterial corona mortis in its clinical implications. Individual evaluation of this risky anatomical structure should be done prior to any surgical interventions. |
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| Keywords: | Corona mortis Obturator vein Obturator artery Retropubic anastomosis |
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