Subacute Course of Common Iliac Arterial Laceration in Lumbar Disc Surgery

Vascular injuries in lumbar disc surgery are serious complications which may be overlooked due to a broad range of clinical manifestations. It is important to be aware of the perioperative implications of this rare occurrence to lower mortality risk. A 20-yr-old man with a right L4-5 lumbar disc pro...

Full description

Bibliographic Details
Main Authors: Choi, Yun Suk, Chung, Young Sun, Sim, Ki-Bum
Format: Online
Language:English
Published: The Korean Academy of Medical Sciences 2013
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546099/
id pubmed-3546099
recordtype oai_dc
spelling pubmed-35460992013-01-22 Subacute Course of Common Iliac Arterial Laceration in Lumbar Disc Surgery Choi, Yun Suk Chung, Young Sun Sim, Ki-Bum Case Report Vascular injuries in lumbar disc surgery are serious complications which may be overlooked due to a broad range of clinical manifestations. It is important to be aware of the perioperative implications of this rare occurrence to lower mortality risk. A 20-yr-old man with a right L4-5 lumbar disc protrusion was operated on routinely under a surgical microscope. A bloody surgical field was noted temporarily during a discectomy along with a decreased blood pressure. After fluid resuscitation with an ephedrine injection, the bleeding soon stopped spontaneously and his vital signs were stabilized. Fifty hours after the operation, the patient showed signs of hypovolemic hypotension with abdominal distension. The right femoral artery pulsation was absent on palpation. An enhanced CT angiography revealed a retroperitoneal hematoma and obstruction of the left common iliac artery. An urgent laparotomy was done to repair the injured vessel by excision and interposition of a graft. The patient had an uneventful recovery.The subacute course of deterioration might have been due to intermittent blood leakage from the lacerated common iliac artery, which was sealed spontaneously. It is very important to pay close attention to post-surgical clinical manifestations to avoid a potentially fatal outcome in lumbar disc surgery. The Korean Academy of Medical Sciences 2013-01 2013-01-08 /pmc/articles/PMC3546099/ /pubmed/23341730 http://dx.doi.org/10.3346/jkms.2013.28.1.167 Text en © 2013 The Korean Academy of Medical Sciences. http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type Open Access Journal
institution_category Foreign Institution
institution US National Center for Biotechnology Information
building NCBI PubMed
collection Online Access
language English
format Online
author Choi, Yun Suk
Chung, Young Sun
Sim, Ki-Bum
spellingShingle Choi, Yun Suk
Chung, Young Sun
Sim, Ki-Bum
Subacute Course of Common Iliac Arterial Laceration in Lumbar Disc Surgery
author_facet Choi, Yun Suk
Chung, Young Sun
Sim, Ki-Bum
author_sort Choi, Yun Suk
title Subacute Course of Common Iliac Arterial Laceration in Lumbar Disc Surgery
title_short Subacute Course of Common Iliac Arterial Laceration in Lumbar Disc Surgery
title_full Subacute Course of Common Iliac Arterial Laceration in Lumbar Disc Surgery
title_fullStr Subacute Course of Common Iliac Arterial Laceration in Lumbar Disc Surgery
title_full_unstemmed Subacute Course of Common Iliac Arterial Laceration in Lumbar Disc Surgery
title_sort subacute course of common iliac arterial laceration in lumbar disc surgery
description Vascular injuries in lumbar disc surgery are serious complications which may be overlooked due to a broad range of clinical manifestations. It is important to be aware of the perioperative implications of this rare occurrence to lower mortality risk. A 20-yr-old man with a right L4-5 lumbar disc protrusion was operated on routinely under a surgical microscope. A bloody surgical field was noted temporarily during a discectomy along with a decreased blood pressure. After fluid resuscitation with an ephedrine injection, the bleeding soon stopped spontaneously and his vital signs were stabilized. Fifty hours after the operation, the patient showed signs of hypovolemic hypotension with abdominal distension. The right femoral artery pulsation was absent on palpation. An enhanced CT angiography revealed a retroperitoneal hematoma and obstruction of the left common iliac artery. An urgent laparotomy was done to repair the injured vessel by excision and interposition of a graft. The patient had an uneventful recovery.The subacute course of deterioration might have been due to intermittent blood leakage from the lacerated common iliac artery, which was sealed spontaneously. It is very important to pay close attention to post-surgical clinical manifestations to avoid a potentially fatal outcome in lumbar disc surgery.
publisher The Korean Academy of Medical Sciences
publishDate 2013
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546099/
_version_ 1611947279287058432