The arteries that commonly contribute to CM are the obturator artery and the inferior epigastric artery. The obturator artery is a branch of the internal iliac artery, supplies the muscles around the hip joint, and follows a trajectory along the pelvic rim, exiting the pelvis through the obturator canal [4, 5].

Fig 1: Animation of an angio-CT on axial view, showing a left corona mortis anastomosing the left inferior epigastric artery with the ipsilateral obturator artery. Incidental finding in a 45-year-old patient with suspected acute aortic syndrome.

Fig 2: (Same patient as figure 1) Animation of an angio-CT on sagittal view, showing the left corona mortis “crowning” the left superior pubic ramus.

The CM typically crosses the superior pubic ramus and may take an arterial or venous form [2].

Fig 3: (Same patient as figure 1) Three-dimensional (3D) angio-CT images showing a corona mortis on the left side of the pelvis (blue arrow) and its absence on the right side.

Fig 4: A. Three-dimensional (3D) angio-CT image of the 45-year-old patient, showing the distance between the CM and the symphisis pubis. B. Axial angio-CT image showing the diameter of the left CM.

Fig 5: A. Three-dimensional (3D) angio-CT image showing a left CM (blue arrow) as incidental finding in a 72-year-old patient evaluated for peripheral vascular disease. The distance between symphis pubis and CM is also shown. B. Axial angio-CT image showing the diameter of the left CM. Note the marked calcification of vessels and compare it with the previous figure. Severe atherosclerosis may hinder the diagnosis of CM.

CT angiography (CTA) has proven effective in identifying CM, with sensitivity and specificity of 90% and 100%, respectively, in non-pelvic fracture cases [2].

Fig 1: Animation of an angio-CT on axial view, showing a left corona mortis anastomosing the left inferior epigastric artery with the ipsilateral obturator artery. Incidental finding in a 45-year-old patient with suspected acute aortic syndrome.

Fig 2: (Same patient as figure 1) Animation of an angio-CT on sagittal view, showing the left corona mortis “crowning” the left superior pubic ramus.

Fig 3: (Same patient as figure 1) Three-dimensional (3D) angio-CT images showing a corona mortis on the left side of the pelvis (blue arrow) and its absence on the right side.

Fig 5: A. Three-dimensional (3D) angio-CT image showing a left CM (blue arrow) as incidental finding in a 72-year-old patient evaluated for peripheral vascular disease. The distance between symphis pubis and CM is also shown. B. Axial angio-CT image showing the diameter of the left CM. Note the marked calcification of vessels and compare it with the previous figure. Severe atherosclerosis may hinder the diagnosis of CM.

Fig 7: Axial CECT images of a patient who suffered trauma due to mechanic fall. Multiple comminuted fracture of the left hemipelvis. This lesions are associated with large extraperitoneal hematoma located within the left retropubic space and pelvic side wall. There is active arterial extravasation (blue arrow) arising from a pelvic branch of the inferior epigastric artery, which anastomoses with the obturator artery (corona mortis). Case courtesy of Craig Hacking, Radiopaedia.org, rID: 185092

Fig 8: (Same patient as figure 7) Frontal DSA confirms arterial extravasation from left CM. Case courtesy of Craig Hacking, Radiopaedia.org, rID: 185092

In trauma or surgical settings, such as pelvic fractures, orthopedic approaches, and hernia repairs, unrecognized CM poses a significant risk of hemorrhage. Awareness and early identification are critical for surgeons and interventional radiologists [3, 6].

Fig 6: A. 3D angio-CT image of a 70-year-old patient, showing bilateral corona mortis (blue arrows) as incidental findings in the pre-operative planning for prostatic artery embolization. B. Intraoperative DSA of the left external iliac artery confirming the finding of left corona mortis (yellow arrow), with the vesicoprostatic trunk arising from the obturator artery (blue arrow).

Fig 7: Axial CECT images of a patient who suffered trauma due to mechanic fall. Multiple comminuted fracture of the left hemipelvis. This lesions are associated with large extraperitoneal hematoma located within the left retropubic space and pelvic side wall. There is active arterial extravasation (blue arrow) arising from a pelvic branch of the inferior epigastric artery, which anastomoses with the obturator artery (corona mortis). Case courtesy of Craig Hacking, Radiopaedia.org, rID: 185092

Fig 8: (Same patient as figure 7) Frontal DSA confirms arterial extravasation from left CM. Case courtesy of Craig Hacking, Radiopaedia.org, rID: 185092

Fig 9: (Same patient as figure 7) Frontal DSA showing successful microcoil embolization of the left CM. Case courtesy of Craig Hacking, Radiopaedia.org, rID: 185092