[Two patients with an initially unrecognised iatrogenic arteriovenous fistula and successful endovascular therapy following lumbar herniotomy and laparoscopic cholecystectomy].
Patient A, 46-year-old woman, underwent lumbar disc surgery in connection with a radicular syndrome and patient B, a 34-year-old man, underwent laparoscopic cholecystectomy. Both patients suffered postoperatively from dyspnoea, high central venous pressure and an abdominal bruit. Both patients had an initially unrecognised, peroperatively caused, arteriovenous fistula between the common iliac artery and the inferior vena cava. Endovascular therapy was successful. Iatrogenic arteriovenous fistulae are rare and often diagnosed late, partly because in some patients the symptoms may only develop after some delay, partly due to unfamiliarity with this complication on the part of the physician. Doppler ultrasound, CT-scanning and angiography may be used for imaging. Endovascular placement of a covered stent to close the arteriovenous fistula is the treatment of choice.
Boonstra
R H
RH
Kennemer Gasthuis, afd. Chirurgie, Haarlem. rh.boonstra@ekit.com
van Tol
C A E
CA
Coster
E
E
Wisselink
W
W
D000328:Adult; D001164:Arteriovenous Fistula / Q000209:etiology* / Q000628:therapy*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007083:Iliac Artery / Q000293:injuries; D007405:Intervertebral Disc Displacement / Q000601:surgery; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000628:therapy*; D015607:Stents; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000293:injuries