RÁCH ĐỘNG MẠCH CHẬU GỐC TRONG PHẪU THUẬT THOÁT VỊ ĐĨA ĐỆM CỘT SỐNG THẮT LƯNG: BÁO CÁO 01 TRƯỜNG HỢP

Abstract

Purpose: Surgical treatment of vascular injuries during dissectomy. Subjects and method: A female patient, aged 66 with strong physical condition, was admitted to the hospital with a diagnose left L4-5 herniated disc. She received surgery to cut off a part of the left L4 lamina, the herniated disc and a few nucleus pulposus. After the disc was removed, blood flowed out lightly but constantly. The sectional areas’ bleeding and nerve root’s vessel were then staunched. The last step was to set drainage and close the incision in layers. The patient felt with a headache, dizziness, nausea, and later fainted. An abdominal ultrasound examination raised suspicion of blood flowing into the abdomen. Monitoring showed a rapid pulse, drop in blood pressure, and unresponsiveness to vasopressor drugs. Resuscitation was performed and the patient was transferred to the vascular intervention room. An angiography presented a torn left common iliac artery. The tear was mended with a stent, after which the patient was transferred back to intensive care unit (ICU) and continue receiving treatment. Results: She was discharged after a week in healthy condition, legs had good movement and sensation, and no urination disorder. Conclusion: Vascular injuries in a discectomy is uncommon. However, it is severe and life-threatening. Surgeons should stay alert to discover and promptly take measures.