Open AccessMajor Vascular Injury during Gynecologic Laparoscopy: Report of a case and review of published cases
Author(s) -
Baadsgaard Sven Erik,
Bille Sørren,
Egeblad Klas
Publication year - 1989
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.3109/00016348909021007
Subject(s) - medicine , surgery , pneumoperitoneum , hematoma , laparoscopy , complication , hemorrhagic shock , vein , fibrous joint , shock (circulatory) , common iliac artery , lesion , radiology , iliac artery , resuscitation
Serious complications following gynecologic laparoscopy are rare. We report a case of a 24‐year‐old woman who had a common iliac artery and vein injured by the trocar, resulting in deep shock. The arterial lesion was repaired with an allograft and the vein sutured. The patient recovered with light sequelae. The literature was reviewed and we found 15 cases described in varying detail. In most cases the injury was caused by the pneumoperitoneum‐needle and in only 2 by the trocar. Characteristically the terminal aorta and its major branches were injured. All the patients had a large retroperitoneal hematoma and only minimal free blood in the peritoneum. Signs of bleeding were nearly always acute. Most lesions could be treated by simple suture. Recovery is the rule, but 2 of the 15 died. Examiner's experience and correct technique are important to prevent this potentially lethal complication which is also probably underreported.