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Giulio Cesare Aranzio (Arantius)

Giulio Cesare Aranzio
(Arantius)

(1530 -1589)   

Italian surgeon and anatomist. Born in Bologna, Giulio Cesare Aranzio is better known by the Latinized version of his name Julius Caesar Arantius. His Italian last name is sometimes spelled Aranzi.

Born in a poor family, Aranzio began his medical studies under the tutelage of his uncle, Bartolommeo Maggi (1477 – 1552), studied medicine at the University of Bologna where he graduated MD in 1556. The same year he became a Professor of Anatomy and Surgery at the in 1556. Arantius was the first lecturer at the University of Bologna to hold a separate professorship of anatomy. Before him, the University would allow any surgeon to perform dissection and lectures.

Arantius had several publications that include:

Observationes Anatomicas (Anatomical Observations)
De Humano Foetu  Opusculum (On the Human Fetus)
De Tumoribus Secundum Locos Affectos (Tumors according to the affected places)
Hippocratis librum de vulneribus capitis commentarius brevis (Short commentary on Hippocrates’ book on head wounds)

Arantius was the first to describe the foramen ovale (fossa ovalis) and the ductus arteriosus, discoveries that were later erroneously ascribed to Leonardo Bottalus (Botal). He also described the nodules in the leaflets of the aortic valve that today bear his name (nodules of Arantius) which he described as being “cartilaginous” in nature. This is not as farfetched as it seems as these nodules can become hypertrophic and harden with age. Arantius was also the first to describe the hippocampus, a formation on the brain associated with the limbic system, mood disorders, and depression.

Arantius was a consummate anatomist and a great surgeon. Apparently he treated nasal polyps, performed nasal reconstructions and a number of surgeries ahead of his time. One of his great anatomical observations was that the blood in the heart did not pass through “invisible pores” in the interventricular septum, but rather exits the heart through the pulmonary trunk, setting the stage for the discovery of circulation by William Harvey (1578 – 1609) We have not been able to find a portrait of Arantius and the only reference is a photograph of a bust with the name “Aranzio” located at the Medical Society in Bologna (Gurunluoglu, 2011)

Sources:
1. “Giulio Cesare Arantius (1530-1589): a surgeon and anatomist: his role in nasal reconstruction and influence on Gaspare Tagliacozzi” . Gurunluoglu R, Gurunluoglu A Ann Plast Surg. 2008 Jun;60(6):717-22
2. “Giulio Cesare Aranzio (Arantius) (1530-89) in the pageant of anatomy and surgery” Gurunluoglu R, Shafighi M, Gurunluoglu A, Cavdar S. J Med Biogr. 2011 May;19(2):63-9
3. “Hippocampus – Why is it studied so frequently?”Radonjic, V. et al Vojnosanit Pregl 2014; 71(2): 195–201
4: “The history of Bolngna University's Medical School over the centuries, A Short Review” Moroni, P. Acta Dermatoven APA Vol 9, 2000, No 2 73-75


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Corona Mortis

Important for inguinal hernia anatomy and surgery, this term is Latin from [corona] meaning "crown' and [mortis] meaning "death'; the "crown or circle of death". The corona mortis (blue arrow) refers to an anatomical variation1, a vascular anastomosis between the obturator and the external iliac vascular systems that passes over Cooper's pectineal ligament and posterior to the lacunar (Gimbernat's) ligament. 

In some cases, the corona mortis is the actual obturator artery that arises from the inferior epigastric artery instead of the internal iliac artery. It can also arise from the external iliac artery. In both cases, it has been called an "aberrant obturator artery". This could be a misnomer, as this anatomical variation can be present in up to 25% of the cases. When present, the corona mortis  can be injured when a surgeon looks to enlarge the femoral ring by opening the lacunar ligament. This vascular structure could even be endangered in a laparoscopic procedure for inguinal of femoral hernia repair and a staple or tack is driven blindly into the pectineal (Cooper's) ligament.

Corona Mortis (A)Image property of: CAA.Inc.Artist: M. Zuptich

Berberoglu states that "although these tiny anastomoses... have been described in classical anatomy textbooks, these texts neglect to mention that theses anastomoses can be life-threatening".

In some rare cases, the corona mortis (aberrant obturator) artery coexists with the normal obturator artery.  Although called a [corona], this anatomical structure is an incomplete circle. In the image, the [corona mortis] is labeled "A".

Sources:
1. Rusu et al: "Anatomical considerations on the corona mortis" Surg Radiol Anat (2010) 32:17–24
2. Berberoglu et al: "An anatomic study in seven cadavers and an endoscopic study in 28 patients" Surg Endosc (2001) 15:72-75