A fatal and unusual iatrogenic fourth right lumbar artery injury complicating wrong-level hemilaminectomy: a case report and literature review

Abstract

The authors describe an unusual case of a fatal iatrogenic fourth lumbar artery injury during left hemilaminectomy in a 38-year-old woman. At autopsy, gross inspection revealed hemoperitoneum with 1,800 ml of free blood and massive retroperitoneal extravasation. A laceration with irregular and jagged margins was detected on the wall of the fourth right lumbar artery. The autopsy and the post-mortem TC investigations demonstrated that wrong-level hemilaminectomy was performed for the herniated disc.

Keywords:

• Fourth right lumbar artery injury
• left hemilaminectomy
• wrong-level hemilaminectomy
• hemoperitoneum

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Patient consent

In this notable case there are no personal-specific medical information about an identifiable living individual and the few data concerning the patient have been sufficiently anonymised (e.g. no name or photographs of the patient are included in the paper).

Moreover, even if the patient is dead, we sought permission from a relative as a matter of courtesy and medical ethics. Unfortunately no relatives were contactable Finally, the authors got the permission to publish the case by the Public Prosecutor who performed the forensic investigations.