Importance of Both Internal and External Iliac Artery Interrogation in Pelvic Trauma as Evidenced by Hemorrhage from Bilateral Corona Mortis with Unilateral Aberrant Origin off the External Iliac Artery

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.

Endovascular Repair of the Blunt Injury to Persistent Sciatic Artery in case of Pelvic Fracture

Background: Endovascular embolization has become a preferred treatment in the management of retroperitoneal bleeding due to pelvic injuries. These techniques have spread across most trauma centers as minimally invasive management of one of the most dreadful conditions in trauma. Methods We present a patient with persistent sciatic artery who arrived at our facility with blunt pelvic trauma suffering from retroperitoneal bleeding. Timely recognition of this anomaly led to the preservation of the vital artery and prevention of the ischemic complication. Conclusions Though embolization of the bleeding has become a routine procedure in most busy trauma centers, precise imaging, recognition of significant anatomic variants and careful intervention planning are essential to prevent substantial complications.