UNIGE document Scientific Article - Case report
previous document  unige:111990  next document
add to browser collection
Title

Tearing of the left iliac vessels in lumbar surgery revealed by multiphase post-mortem CT-angiography (MPMCTA)

Authors
Zerlauth, Jean-Baptiste
De Froidmont, Sébastien
Published in Legal Medicine. 2016, vol. 20, p. 44-8
Abstract Lumbar surgery is regularly applied in cases of discal hernia and acquired lumbar stenosis. In this report, we present a case of a laceration in the left common iliac artery and iliac vein during a lumbar surgery and discuss the literature concerning this kind of event. In the present case, the surgical procedure was followed by a sudden decrease in blood pressure, and the surgeon discovered an intra-abdominal haemorrhage that led to the patient's death. Postmortem investigation confirmed the intra-abdominal haemorrhage and revealed a laceration of the proximal portion of the left common iliac artery and left iliac vein. The source of bleeding could be detected especially thanks to multi-phase postmortem CT angiography (MPMCTA), which was performed prior to autopsy. We also found a haemorrhagic path through the intervertebral disc between the L4-L5 vertebrae, caused by the surgeon's instrument (pituitary rongeur). To date, a few cases have been described of iatrogenic death resulting from a tear in the iliac vessels during lumbar surgery, but not from the postmortem perspective. Such investigations have recently been modernized thanks to the introduction of forensic imaging. In particular, MPMCTA offers new possibilities in postmortem investigations and can be considered the new gold standard for investigating deaths related to medical intervention. Here we describe the first case of a death during lumbar surgery using this new method.
Keywords AutopsyComputed Tomography AngiographyFemaleHemorrhage/diagnosis/etiologyHumansIatrogenic DiseaseIliac Artery/injuriesIliac Vein/injuriesLacerationsLumbosacral Region/surgeryMiddle Aged
Identifiers
PMID: 27161923
Full text
Article (Published version) (1 MB) - document accessible for UNIGE members only Limited access to UNIGE
Structures
Research group Groupe Silke Grabherr (969)
Citation
(ISO format)
VILARINO, Raquel et al. Tearing of the left iliac vessels in lumbar surgery revealed by multiphase post-mortem CT-angiography (MPMCTA). In: Legal Medicine, 2016, vol. 20, p. 44-8. https://archive-ouverte.unige.ch/unige:111990

13 hits

0 download

Update

Deposited on : 2018-12-05

Export document
Format :
Citation style :