SciELO - Scientific Electronic Library Online

vol.53 issue4Autonomic hyperreflexia in tetraplegic pregnant patient: case reportLatex allergy: accidental diagnosis after urological procedure. Case report author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




Related links


Revista Brasileira de Anestesiologia

Print version ISSN 0034-7094On-line version ISSN 1806-907X


MOREIRA, Wanderley Rodrigues  and  XAVIER, Hélio Humberto Cançado. Left iliac artery injury during lumbar laminectomy: case report. Rev. Bras. Anestesiol. [online]. 2003, vol.53, n.4, pp.489-495. ISSN 0034-7094.

BACKGROUND AND OBJECTIVES: Iliac artery injury during laminectomy is an uncommon, however very serious event. This report aimed at presenting a case of left iliac artery injury in patient submitted to lumbar laminectomy under spinal anesthesia, that was clinically manifested in the immediate postoperative period, seven hours after beginning of surgery. CASE REPORT: Male patient, physical status ASA I, 31 years old, 68 kg, submitted to lumbar laminectomy in prone position under spinal anesthesia in L2-L3 interspace with 20 mg 0.5% hyperbaric bupivacaine and 25 µg fentanyl. Surgery went on normally and seven hours after its beginning, already in the postoperative period, patient presented arterial hypotension, tachycardia, agitation and diffuse abdominal pain. An abdominal CT-scan showed extensive retroperitoneal hematoma and exploratory laparotomy revealed left iliac artery injury. After laparotomy, patient recovered without intercurrences. CONCLUSIONS: General anesthesia is mandatory depending on patients’ positioning and physical status. This case calls the attention to the fact that regardless of the anesthetic technique, there might be no operative field bleeding in the presence of vascular injury because this bleeding may be late. In our case, clinical manifestation was seven hours after beginning of surgery, when the patient had already recovered from anesthesia. However, the event (arterial hypotension) could have happened in the intraoperative period.

Keywords : ANESTHETIC TECHNIQUES [Regional]; ANESTHETIC TECHNIQUES [spinal block]; COMPLICATIONS [hemorrhage]; SURGERY [Orthopedic]; SURGERY [laminectomy].

        · abstract in Portuguese | Spanish     · text in Portuguese     · Portuguese ( pdf epdf )


Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License