Sponsors   Medical Terminology Daily (MTD) is a blog prepared by Clinical Anatomy Associates, Inc. as a service to the medical community, medical students, and the medical industry. We will post a workweek daily medical or surgical term, its meaning and usage, as well as biographical notes on anatomists, surgeons, and researchers through the ages. Be warned that some of the images used depict human anatomical specimens.

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A Moment in History 
Václav Treitz
Dr. Václav Treitz
(1819 - 1872) 

Also known as Wenzel Treitz, Dr. Václav Treitz was born in Hostomice, Bohemia. He attended the Charles-Ferdinand University in Prague studying humanities and medicine, receiving his medical degree in 1846. Treitz started postgraduate work at the Vienna General Hospital (Allgemeines Krankenhaus), where Joseph Skoda (1805-1881) was a proponent of “therapeutic nihilism” which stated that “drug treatment usually does more harm than good”, so a minimalistic or even pessimistic approach to diseases was used.

Large numbers of women at this hospital died of “puerperal fever” an postpartum uterine infection due to contamination by the unwashed hands of physicians and utter lack of cleanliness (septic technique had not been yet described). It was during Treitz’s time at the Vienna General Hospital that Ignaz Philipp Semmelweis (1818 – 1865) stated his initial observations on asepsis. Treitz later became a follower of Semmelweis’ and Lister’s teachings and techniques.

In 1852 Treitz was appointed Professor of Pathological Anatomy in the Jagellonian University in Prague.

In 1853 he published a paper ("Ueber einen neuen Muskel am Duodenum des Menschens" ) describing a new muscle he discovered at the duodenojejunal junction, later to be known as the eponymic “muscle of Treitz”; the fold of peritoneum over the muscle of Treitz is known today as the "ligament of Treitz". Treitz also described a paraduodenal retroperitoneal hernia that occurs at the paraduodenal recess, just lateral to the ligament of Treitz.

A staunch proponent of Czechoslovakian independence and language, Treitz was publicly attacked for his medical theories and nationalistic beliefs. Isolated and depressed, Treitz committed suicide in 1872.

1. "Václav Treitz (1819-1872): Czechoslovakian Pathoanatomist and Patriot” Fox, RS; Fox, CG; Graham, WP. World J. Surg. 9, 361-366, 1985
2. "Treitz of the ligament of Treitz". Haubrich, W S. (2005) Gastroenterology, 128 (2), 279
3. "Preserving Treitz's muscle in hemorrhoidectomy". Gemsenjäger, E Diseases of the Colon & Rectum (1982), 25 (7), p. 633.
4. “The Muscle Of Treitz And The Plica Duodeno-Jejunalis” Crymble, PT. The British Medical Journal, Vol. 2, No. 2598 (1910), 1156-1159
Original image courtesy of Wikipedia.org.

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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".

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