During laparoscopic TEP repair, the surgeon identifies the 'corona mortis'. What is the clinical significance of this structure?
- A It is the landmark for the triangle of doom containing the external iliac vessels
- B It is an anastomotic vessel between the obturator and inferior epigastric or external iliac systems that can cause troublesome bleeding if injured ✓
- C It is the site where the ilioinguinal nerve enters the inguinal canal
- D It is the point where the hernia sac should be ligated
Correct answer: B. It is an anastomotic vessel between the obturator and inferior epigastric or external iliac systems that can cause troublesome bleeding if injured
Explanation
The corona mortis (crown of death) is a vascular anastomosis between the obturator artery (or pubic branch of inferior epigastric) and the external iliac or femoral system, present in the retropubic space. Injury during mesh fixation in TEP or Lichtenstein repair can cause significant hemorrhage. It lies superior to the pubic ramus and must be avoided when tacking or suturing mesh medially.
Reference: Gray's Anatomy, 42nd ed.
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Written and medically reviewed by the StethoPrep medical team.