Iliac artery injury during lumbar microdiscectomy
Karwacki, Z.; Witkowska, M.łg.; Łasińska-Kowara, M.; Słoniewski, P.ł; Wojciechowski, J.
Anestezjologia Intensywna Terapia 42(1): 24-26
2010
ISSN/ISBN: 0209-1712 PMID: 20608211 Document Number: 643468
Accidental laceration of major abdominal vessels during lumbar disc surgery is a relatively rare complication that requires rapid diagnosis and management. A 25-yr-old woman, operated on for an L4-L5 disc hernia, developed cardiovascular collapse after disc removal. This was treated with volume replacement and ephedrine, and a postoperative CT scan revealed a large retroperitoneal haematoma. During an immediate laparotomy, a 10 cm laceration of the left iliac artery was repaired and massive blood loss replaced (to lowest haemoglobin concentration during the surgery was 2.1 mmol L(-1)).The patient made a full recovery. In any case of unexpected hypotension during lumbar disc herniation surgery, accidental vascular damage should be suspected and a CT scan performed immediately.