[Wounding of an iliac artery during celioscopy]

J Chir (Paris). 1993 Apr;130(4):161-4.
[Article in French]

Abstract

Vascular accidents during celioscopy are rare but potentially serious. Arterial injuries usually involve the aortic bifurcation and are generally recognized and treated as emergencies. In the present case, a transfixing wound of the right common iliac artery provoked by a trocar during gynecological celioscopy in a 36 year old woman was diagnosed secondarily, the posterior orifice being unrecognized during laparotomy to control hemorrhage. A false iliac artery aneurysm was detected 2 months later when she presented signs of a compressive retroperitoneal hematoma confirmed by arteriography and scan images. The common iliac artery was ligatured through a right retroperitoneal approach with extra-anatomical revascularization by a crossed iliofemoral venous shunt. The postoperative course was uncomplicated apart from a right cruralgia sequela. Immediate circumferential dissection for treatment of aortic bifurcation injuries is recommended, to avoid missing a transfixing wound, and to allow direct restoration usually by simple suture. In contrast, secondary treatment is complex, raises problems of arterial reconstruction, and cannot always prevent functional sequelae.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Angiography
  • Blood Vessel Prosthesis
  • Endoscopy / adverse effects*
  • Female
  • Hematoma / diagnostic imaging
  • Hematoma / etiology*
  • Hematoma / surgery
  • Humans
  • Iatrogenic Disease
  • Iliac Artery / injuries*
  • Iliac Artery / physiopathology
  • Iliac Artery / surgery
  • Postoperative Complications
  • Retroperitoneal Space / diagnostic imaging
  • Retroperitoneal Space / physiopathology*
  • Tomography, X-Ray Computed