Iatrogenic left internal iliac artery perforation during lumbar discectomy
Journal
Acta Anaesthesiologica Taiwanica
Journal Volume
47
Journal Issue
4
Pages
196-199
Date Issued
2009
Author(s)
Abstract
Iatrogenic intra-abdominal vascular injury can result from lumbar discectomy via the posterior approach. Although it is well known and documented in the literature, few anesthesiologists have personal experience with this life-threatening incident. Here, we report a patient who sustained perforation of the left internal iliac artery at the L4-5 level during posterior lumbar discectomy. The patient experienced refractory hypotension with tachycardia at the end of surgery, even with prompt fluid resuscitation and medical treatment. Abdominal distension and tenderness of the left lower abdominal quadrant were also noted. Emergency laparotomy was performed by the consulting vascular surgeon and revealed perforation of the left internal iliac artery. The vascular injury was successfully repaired. It is important that, as anesthesiologists, we must be aware of this potentially fatal complication. Prompt diagnosis and immediate laparotomy to control hemorrhage can result in favorable outcomes. ?2009 Taiwan Society of Anesthesiologists.
Subjects
Discectomy, lumbar; Hypotension; Iliac artery, internal
SDGs
Other Subjects
dopamine; fentanyl; rocuronium; sevoflurane; thiopental; abdominal distension; abdominal pain; adult; artery perforation; article; case report; echography; emergency surgery; endotracheal intubation; female; fluid resuscitation; human; hypotension; iatrogenic disease; intervertebral diskectomy; laparotomy; laryngoscopy; left internal iliac artery perforation; lumbar disk hernia; retroperitoneal hematoma; tachycardia; vascular surgery
Type
journal article