title: Iatrogenic left common iliac artery and vein perforation during lumbar discectomy: a fatal case.
abstract: Iatrogenic vascular injury during lumbar disk surgery, although rare, is a serious complication, and when it does occur, can be sudden and life-threatening. The risk of injury to the pelvic vessels intra-operatively can be explained by the close proximity of the retroperitoneal vessels to the vertebral column therefore causing injury to the anterior longitudinal ligament, which can give access to the retroperitoneal space. If signs of circulatory instability are noted during lumbar disk surgery, early diagnosis of vascular injury and urgent transperitoneal surgery or emergency stenting can save the patient's life. Here, is presented the case of a 52-year-old man who underwent an elective lumbar discectomy for a rightward disk herniation in the L4-L5 intervertebral space and died 12h after the operation for a hemorrhagic shock due to a severe intra-abdominal hemorrhage following iatrogenic left common iliac artery and vein perforation during lumbar discectomy.
authors.affiliation: Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00185 Rome, Italy.
authors.forename: Francesco Paolo
authors.initials: FP
authors.lastname: Busardò
authors.affiliation: Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00185 Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Frati
authors.affiliation: Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.
authors.forename: Iacopo
authors.initials: I
authors.lastname: Carbone
authors.affiliation: SMDLP, Via. Principe Di Villafranca, 91, 90141 Palermo, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Pugnetti
authors.affiliation: Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00185 Rome, Italy. Electronic address: vfinesc@tin.it.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Fineschi
mesh_terms: D017586:Diskectomy / Q000009:adverse effects*; D017809:Fatal Outcome; D006801:Humans; D007083:Iliac Artery / Q000293:injuries*; D007084:Iliac Vein / Q000293:injuries*; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D019300:Medical Errors; D008875:Middle Aged; D012771:Shock, Hemorrhagic / Q000209:etiology
keywords: Fatal case; Iliac vessels; Lumbar discectomy; Vascular injury