Presentation
Mechanic fall. Tachycardia and hypotension.
Patient Data
Comminuted left superior and inferior pubic rami fractures. Multiple comminuted fracture of the left ilium, the dominant fracture extends into the left sacroiliac joint and involves the inferior lateral sacral ala. Further comminuted fracture involving the left iliac crest.
The left superior pubic rami fracture is associated with large extraperitoneal hematoma located within the left retropubic space and pelvic side wall. There is active arterial extravasation arising from a pelvic branch of the inferior epigastric artery, which anastomoses with the obturator artery (corona mortis). The bladder is displaced superiorly and toward the right, with an IDC in situ.
Microcoil embolization of the left corona mortis branch.
Case Discussion
The corona mortis is a variant of pelvic arterial anatomy that represents an anastomosis between the inferior epigastric and obturator arteries. It passes over the superior pubic ramus where it is at risk of injury during pelvic trauma.
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