title: Iatrogenic major vascular injury during lumbar discectomy: report of three cases.
abstract: Iatrogenic vascular injury rarely occurs during lumbar disc surgery and can be fatal if it is not recognized instantly. In this paper we aim to introduce three iatrogenic vascular injuries that occurred during the lumbar disc surgery. The first case was consulted because of the sudden hypotension attack during lumbar disc surgery. The left common iliac artery and bilateral common iliac vein injuries were detected in emergency laparotomy, and repaired primarily. The second case was consulted to our clinic because of the hypotension attack at the first postoperative day. Left common iliac artery and vein injuries were diagnosed by CT angiography. Left common iliac vein was ligated and left common iliac arterial injury was repaired primarily by laparotomy. The third case was referred to our clinic for left lower extremity ischemia. Left common iliac artery injury was diagnosed by simple physical examination. Reconstruction by PTFE graft interposition was performed. The first patient died due to disseminated intravascular coagulation at the early postoperative period. Pulmonary embolus developed in the iliac vein ligated patient but was well treated by anticoagulant therapy. The last patient was discharged without any problem. Two of the patients are well on long-term follow-up.
authors.affiliation: Istanbul University, Istanbul Faculty of Medicine, Department of General Surgery, Fatih, Istanbul, Turkey. mtnkeskin@yahoo.com
authors.forename: Metin
authors.initials: M
authors.lastname: Keskin
authors.forename: Kursat Rahmi
authors.initials: KR
authors.lastname: Serin
authors.forename: Fatih Ata
authors.initials: FA
authors.lastname: Genc
authors.forename: Murat
authors.initials: M
authors.lastname: Aksoy
authors.forename: Fatih
authors.initials: F
authors.lastname: Yanar
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kurtoglu
mesh_terms: D000328:Adult; D001012:Aorta, Abdominal / Q000293:injuries / Q000601:surgery*; D017586:Diskectomy / Q000379:methods; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000293:injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000175:diagnosis / Q000601:surgery*; D055815:Young Adult