Herskowitz Michael, Walsh James, Lilly Meghan, McFarland Kimberly
Department of Interventional Radiology, Kings County Hospital, 451 Clarkson Ave, Brooklyn, NY 11203, USA.
Case Rep Radiol. 2019 Jul 8;2019:6734816. doi: 10.1155/2019/6734816. eCollection 2019.
Transcatheter angiography and embolization has long been recognized as the gold standard for patients with hemodynamic instability secondary to blunt pelvic trauma. While often the bleeding source can be readily localized based on the distribution of extravasation on preprocedural Computed Tomographic Angiography, one should be cautious in assessment for aberrant anatomy. A variant obturator artery originating from the inferior epigastric branch of the external iliac artery is commonly referred to as the corona mortis. We present a case of blunt pelvic trauma in which a patient demonstrated extravasation in the anterior distributions of both internal iliac arteries. Following embolization of bilateral internal iliac arteries, identification and embolization of bilateral corona mortis branches was crucial to achieving hemodynamic stability in this patient.
经导管血管造影和栓塞术长期以来一直被认为是钝性骨盆创伤继发血流动力学不稳定患者的金标准。虽然通常可以根据术前计算机断层血管造影上造影剂外渗的分布很容易地定位出血源,但在评估异常解剖结构时应谨慎。起源于髂外动脉腹壁下分支的变异闭孔动脉通常被称为死亡冠。我们报告一例钝性骨盆创伤病例,该患者双侧髂内动脉前部均出现造影剂外渗。在双侧髂内动脉栓塞后,识别并栓塞双侧死亡冠分支对于该患者实现血流动力学稳定至关重要。