|Table of Contents|

Observation of corona mortis in inguinal hernia patients by laparoscopy and CT angiography



Research Field:
Publishing date:



Observation of corona mortis in inguinal hernia patients by laparoscopy and CT angiography


FU Zhaojun WEI Jian YANG Yuhui LI Minlong TIAN Xiaojun HU Nan

First Department of General Surgery, the Fourth People’s Hospital of Zigong City, Zigong, Sichuan Province, 643000, China


corona mortis laparoscope computed tomography angiography inguinal hernia occurrence rate

R322.12; R656.21; R814.42

Objective     To observe the corona mortis in inguinal hernia patients under laparoscopic surgery with CT angiography (CTA), and investigate the anatomic features and clinical significances of this variant vascular anastomosis in patients with different types of hernia. Methods      A total of 48 patients with inguinal hernia (direct hernia or oblique hernia) admitted in our department between June 2015 and October 2016 were enrolled in this study. They were 33 males and 15 females, at a mean age of  61.0±15.5 years. CTA scanning was performed before the operation. All patients underwent laparoscopic hernia repair. The conditions of corona mortis were collected, and analyzed with clinical data and radiological results. Results     Among the 48 cases, there were totally 56 sides involved (21 sides of direct hernia and 35 sides of oblique hernia). The occurrence rate of corona mortis was 58.9% (33/56). The distance from the blood vessels to pubic symphysis midpoint was 54.4±6.9 mm. The average diameter of arteries in the corona mortis was 2.2±0.8 mm, obviously smaller than that of the veins (2.8±1.1 mm, P<0.05). The occurrence of corona mortis was significantly lower in the patients with direct hernia than those with oblique hernia (P<0.05), so were that of corona mortis in arteries (P<0.05). The males had significantly higher occurrence of corona mortis in veins than the females (P<0.05), while older onset age, larger blood vessel diameter, older in those with direct than oblique hernia were found in male patients (P<0.05). Conclusion     The occurrence rate of corona mortis is higher in the oblique than direct hernia patients, and in the males than the females. The blood vessels of corona mortis are involved in blood supply of the abdominal wall and can slow its degradation.


[1]PUA U, TEO L T. Prospective diagnosis of corona mortis hemorrhage in pelvic trauma[J]. J Vasc Interv Radiol, 2012, 23(4): 571-573. DOI: 10.1016/j.jvir.2011.12.018.
[2]赵渝,王学虎. 腹股沟疝修补术血管并发症的预防与治疗[J]. 中华消化外科杂志, 2016, 15(10): 978-981. DOI: 10.3760/cma.j.issn.1673-9752.2016.10.008.
ZHAO Y, WANG X H. Prevention and treatment of vascular complications of inguinal hernia repair[J]. Chin J Dig Surg, 2016, 15(10): 978-981. DOI: 10.3760/cma.j.issn.16739752.2016.10.008.
[3]JAMES G, BITTNER I V. Incarcerated/Strangulated Hernia: Open or Laparoscopic?[J]. Adv Surg, 2016, 50(1): 67-78. DOI: 10.1016/j.yasu.2016.03.006.
[4]杨峻峰, 肖民辉, 何正宇, 等. 经脐单孔腹腔镜输尿管及肾盂切开取石术18例临床分析[J]. 第三军医大学学报, 2017, 39(1): 95-100. DOI: 10.16016/j.10005404.201607083.
YANG J F, XIAO M H, HE Z Y,et al. Transumbilical laparoendoscopic singlesite ureterolithotomy and nephrolithotomy: report of 18 cases[J]. J Third Mil Med Univ, 2017, 39(1): 95-100. DOI: 10.16016/j.1000-5404.201607083.
[5]魏健,付召军,杨玉辉,等. 腹腔镜全腹膜外疝修补术中死冠血管的解剖及临床意义[J]. 中国普外基础与临床杂志, 2017, 24(2): 185-189. DOI: 10.7507/1007-9424.201606013.
WEI J,FU Z J,YANG Y Y,et al. Anatomy of mortis corona vascular and its clinical significances in laparoscopic total extraperitoneal hernia repair [J]. Chin J Bases Clin General Surg, 2017, 24(2): 185-189. DOI:10.7507/10079424.201606013.
[6]DIXON S, ANTHONY S, UBEROI R. Corona mortis artery as a cause of a type Ⅱ endoleak in an internal arteryaneurysm[J]. J Vasc Interv Radiol, 2011, 22(11): 1634-1635. DOI: 10.1016/j.jvir.2011.07.006.
[7]杨柳青,张磊,文利. CT头面部三维重建在颅缝早闭中的诊断价值[J]. 第三军医大学学报, 2016, 38(8): 881-884. DOI:10.16016/j.1000-5404.201509075.
YANG L Q,ZHANG L,WEN L.Value of CT head facial 3D reconstruction in diagnosis of craniosynostosis[J]. J Third Mil Med Univ, 2016, 38(8): 881-884. DOI: 10.16016/j.10005404.201509075.
[8]OMAR C S, SALVADOR P S, MARIA  A M, et al. Urgent treatment of incarcerated obturator hernias by laparoscopic hernioplasty. Case report and review of the literature[J]. Rev Hispanoam  Hernia, 2014, 2(1): 17-21. DOI: 10.1016/j.rehah.2013.10.002.
[9]ABET E, DUCHALAIS E, DENIMAL F, et al. Laparoscopic incisional hernia repair: long term results[J]. J Visc Surg, 2014, 151(2): 103-106.  DOI: 10.1016/j.jviscsurg.2014.01.012.
[10]TAUSSIG J S, REQUARTH J A, BETTMANN M. Abstract No. 283: Corona Mortis: An important vascular variant in pelvic trauma[J]. J Vasc Interv Radiol, 2008,19(2): S105-S106. DOI: 10.1016/j.jvir.2007.12.321.
[11]孙善平, 崔兆清, 章阳. CoronaMortis血管的解剖学特征及在腹股沟疝修补术中的研究[J]. 中华疝和腹壁外科杂志(电子版), 2013, 7(6): 8-9. DOI: 10.3877/cma.j.issn.1674-392X.2013.06.004.
SUN S P,CUI Z Q,YHANG Y,et al.Corona Mortis vascular anatomy and research in inguinal hernia repair[J]. Chin J Hernia Abdom Wall Surg(Electr Ed), 2013, 7(6): 8-9. DOI: 10.3877/cma.j.issn.1674392X.2013.06.004.
[12]NAYAK S B, DEEPTHINATH R, PRASAD A M, et al. A South Indian cadaveric study on obturator neurovascular bundle with a special emphasis on high prevalence of venous corona mortis[J].Injury, 2016, 47(7): 1452-1455. DOI: 10.1016/j.injury.2016.04.032.
[13]SMITH J C,GREGORIUS J C,BREAZEALE B H, et al.The corona mortis, frequent vascular variant susceptible to bluntpelvic trauma: identification at routine multidetector CT[J]. J Vasc Interv Radiol, 2009, 20(4): 455-460. DOI: 10.1016/j.jvir.2009.01.007.
[14]P-LISSIER E,NGO P,ARMSTRONG O.Tratamiento quirúrgico de las hernias obturatrices[J]. EMCTécnicas QuirúrgicasAparato Digestivo, 2010, 26(3): 1-5. DOI: 10.1016/s12829129(10)70115x.
[15]谢炜,肖林康,张雷,等. 单孔腹腔镜与传统腹腔镜胆囊切除对胆囊良性疾病的疗效对比分析[J]. 第三军医大学学报, 2015, 37(19): 1989-1992. DOI: 10.16016/j.1000-5404.201501208.
XIE W, XIAO L K, ZHANG L, et al. Clinical outcomes of singleincision laparoscopic cholecystectomy versus 3port laparoscopic cholecystectomy[J]. J Third Mil Med Univ, 2015, 37(19): 1989-1992. DOI: 10.16016/j.1000-5404.201501208.
[16]ESPOSITO C, ESCOLINO M, TURR-F, et al. Current concepts in the management of inguinal hernia and hydrocele in pediatric patients in laparoscopic era[J]. Semin Pediatr Surg, 2016, 25(4): 232-240. DOI:10.1053/j.sempedsurg.2016.05.006.
[17]VIKTORIN-BAIER P, RANDAZZO M, MEDUGNO C, et al. Internal Hernia Underneath an Elongated External lliac Artery: A Complication After Extended Pelvic Lymphadenectomy and Robotic-assisted Laparoscopic Prostatectomy[J]. Urology Case Reports, 2016, 8: 9-11. DOI: 10.1016/j.eucr.2016.05.003.
[18]BECK M. Tratamiento laparoscópico de las hernias inguinales del adulto por vía totalmente extraperitoneal[J]. EMCTécnicas QuirúrgicasAparato Digestivo, 2014, 30(2): 1-13. DOI: 10.1016/s1282-9129(14)67353-0.
[19]HOLIHAN J L, BONDIE I, ASKENASY E P, et al. Sublay versus underlay in open ventral hernia repair[J]. J Surg Res, 2016, 202(1): 26-32.  DOI: 10.1016/j.jss.2015.12.014.
[20]YETIIR F, SALMAN AE, -ZL-O, et al. An alternative anterior tension free preperitoneal patch technique by help of the endoscope for femoral hernia repair[J]. Int J Surg, 2013, 11(9): 962-966. DOI: 10.1016/j.ijsu.2013.06.008.


Last Update: 2017-08-23