Life-Threatening Iliac Artery Injury During Lumbar Discectomy: Successful Management with Massive Transfusion
DOI:
https://doi.org/10.14744/ajh.81Keywords:
vascular injury, iliac artery, massive transfusion, Lumbar discectomy, case reportAbstract
Major vascular injury during lumbar discectomy is a rare but potentially fatal complication, with an incidence of 0.01–0.05%. We present a 49-year-old female with systemic lupus erythematosus who developed hemorrhagic shock due to a common iliac artery injury during single-level lumbar discectomy. The patient experienced sudden hypotension and tachycardia intraoperatively. Emergency laparotomy revealed a 6500 mL blood loss; massive transfusion protocol was initiated, and the artery was repaired with a Dacron graft. A total of 11 units of red blood cells, 2 units of platelets, 6 units of cryoprecipitate, and 6 units of plasma were transfused. The patient stabilized postoperatively and was discharged without neurological deficit on day 12. This case highlights the importance of early recognition, rapid multidisciplinary intervention, and massive transfusion in the management of major vascular injuries during lumbar discectomy to improve patient outcomes.
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