Iatrogenic left common iliac artery and vein perforation during lumbar discectomy: a fatal case

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.