Iliac artery injury during lumbar microdiscectomy.
BACKGROUND
Accidental laceration of major abdominal vessels during lumbar disc surgery is a relatively rare complication that requires rapid diagnosis and management.


METHODS
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.


CONCLUSIONS
In any case of unexpected hypotension during lumbar disc herniation surgery, accidental vascular damage should be suspected and a CT scan performed immediately.
Karwacki
Zbigniew
Z
Department of Neuroanaesthesiology, Medical University of Gdańsk. zkarw@gumed.edu.pl
Witkowska
Małgorzata
M
Łasińska-Kowara
Magdalena
M
Słoniewski
Paweł
P
Wojciechowski
Jacek
J
D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control; D017586:Diskectomy / Q000009:adverse effects*; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007083:Iliac Artery / Q000000981:diagnostic imaging* / Q000293:injuries*; D007403:Intervertebral Disc / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D022125:Lacerations / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery; D008159:Lumbar Vertebrae / Q000601:surgery*; D014057:Tomography, X-Ray Computed