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Inferior Mesenteric Artery Injury in Post-lumbar Microdiscectomy: A Case Report
Abdullah K Aljohani1, Mohammed Khalid Bin Yunus1, Albaraa A Fallatah1
1Medicine and Surgery, Taibah University, Medina, SAU.
Abstract:
Iatrogenic vascular injury during lumbar microdiscectomy is a rather rare complication, but it can have fatal consequences. Here, we report a patient who underwent an L5-S1 microdiscectomy, which was complicated by inferior mesenteric artery injury. The patient presented in the recovery room with symptoms of hypotension and tachycardia after the operation which was successfully managed by endovascular embolization. The patient was positioned in a prone position, which may have contributed to the development of vascular injury. To prevent potential complications, we advised using the Jackson table rather than a standard surgical table and thoroughly inspecting the abdomen and pelvis prior to the operation.
Insights
Iatrogenic vascular injury during lumbar microdiscectomy is rare but serious. A patient developed inferior mesenteric artery injury after L5-S1 microdiscectomy, successfully treated with endovascular embolization.
Area of Science:
- Neurosurgery
- Vascular Surgery
- Medical Imaging
Background:
- Iatrogenic vascular injury is a rare but potentially fatal complication of lumbar microdiscectomy.
- The L5-S1 level is particularly susceptible due to anatomical proximity to major vessels.
Observation:
- A patient undergoing L5-S1 microdiscectomy sustained an injury to the inferior mesenteric artery.
- The patient presented with hypotension and tachycardia in the recovery room post-operatively.
Findings:
- The inferior mesenteric artery injury was successfully managed with endovascular embolization.
- The prone positioning during surgery may have contributed to the vascular injury.
Implications:
- Recommendations for prevention include using a Jackson table instead of a standard surgical table.
- Thorough pre-operative inspection of the abdomen and pelvis is advised to mitigate risks.
