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

Dr. Jean-Francois Calot  
Jean-Francois Calot 
(1861 – 1944)

French physician and anatomist, Jean-Francois Calot was born in Arrens-Marsous, a small farming community of the Hautes-Pyrénées. He received his bachelor degree in 1880 at Saint-Pe de Bigorre,  and then continued to study Medicine at the University of Paris, where he worked as an anatomy prosector. His doctoral thesis “De La Cholecystectomie” (On Cholecystectomy) was published in 1890 and republished in 1891.

Although his main interest laid in orthopedics and tuberculosis, Calot’s name is eponymically tied to an anatomical landmark described in his thesis, the “Triangle of Calot”, a triangular area that includes the biliary ducts associated with the gallbladder and the vascular supply to the gallbladder. This is an important region because of the high number of anatomical variations found in the area.

There is a discrepancy between the original description of this triangular region by Calot and what is used today. For more information, click on this link to read more on the “Triangle of Calot”, also known as the “cystohepatic triangle”.

During his medical career Calot worked at several French hospitals including the Rothschild hospital where he became Chief of Surgery. He was also the Chief of Surgery for the Cazin-Perrochaud Hospital, and the Orthopedic Institute of Berck-sur-Mer

During his orthopedic career Calot published many books “Chirurgie et orthopédie de guerre”, “Les maladies qu'on soigne à Berck”, “Berck et ses traitements : les raisons de sa supériorité”, but his opus magnus is the book “« L'orthopédie indispensable aux praticiens” (Indispensable orthopedics for practitioners).

Calot is also known for his treatment of tuberculotic abscesses, and a conservative approach to musculoskeletal tuberculosis. The surgical approach of the times was to surgically open and clean the tuberculotic bone. Calot is known to have said “Ouvrir la tuberculose, c'est ouvrir la porte à la mort” (To open the tuberculosis is to open the door to death).

Continuing his studies and treatment of tuberculosis, on December 22nd, 1896 Calot presents the the French Academy of Medicine a study of the treatment of 37 patients with hyperkyphosis due to Pott’s disease, a tuberculotic spinal deformity, named after Sir Percival Pott. This method included traction and a brace. The following image shows this treatment. Dr. Calot is standing at the center, looking at the patient.

Dr. Jean-Francois Calot and the treatment of Pott's disease

In 1900 Calot founded the “Orthopedic Institute of Berck” which today is known as “Calot’s Institute of Berck-sur-Mer”.

Sources:
1. “Calot's triangle” Abdalla S, Pierre S, Ellis H. Clin Anat. 2013 May;26 (4):493-501
2. “La Vie et l'OEuvre de François Calot, chirurgien orthopédiste de Berck” Loisel, P. (in French). Report presented at Société Française d'Histoire de la Médecine on 18 March 1987
Original image courtesy of the National Library of Medicine


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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