Delayed iliac artery thrombosis after blunt trauma during operative laparoscopy

Major vascular injury during laparoscopic surgery is an uncommon but serious complication. A small number of earlier case reports describe delayed diagnosis of vascular lacerations. Herein we report a unique case of a robot-assisted laparoscopic resection of an obstructed uterine horn, complicated by delayed postoperative presentation of a common iliac artery thrombus without extravascular hemorrhage. The injury was likely caused by blunt trauma to the exterior of the vessel with damage to the vascular intima and subsequent dissection. Meticulous surgical technique, accurate diagnosis, and subsequent treatment are essential to decrease morbidity from such major vascular injuries at the time of laparoscopy.