Small bowel entrapment as a rare complication of lumbar micro discectomy: Case report and literature review

腰椎微创椎间盘切除术后罕见并发症:小肠受压——病例报告及文献综述

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Abstract

INTRODUCTION: Laminectomy with lumbar disc excision remains the standard surgical approach for the management of lumbar disc herniation. While the incidence and nature of common complications associated with this procedure are well-documented, ventral perforation leading to intestinal injury is an exceptionally rare occurrence. However, when it does occur, it can result in severe and potentially life-threatening consequences. CASE PRESENTATION: We present the case of a 47-year-old male who developed an acute abdomen on the second postoperative day following an L5-S1 discectomy. Exploratory laparotomy revealed small bowel entrapment. Surgical management included segmental resection of the affected bowel segment with the creation of a double ileostomy. DISCUSSION: Although exceedingly rare, intestinal injuries secondary to ventral perforation during lumbar discectomy can have serious repercussions. Adequate preoperative surgical planning, careful selection of the surgical approach, and meticulous dissection are critical in minimizing the risk of ventral perforation and subsequent bowel injury. CONCLUSION: Intestinal injury should be recognized as a potential but uncommon complication of lumbar disc surgery, particularly in patients presenting with acute abdominal symptoms or persistent wound infections postoperatively. Prompt diagnosis and timely surgical intervention are crucial in preventing severe morbidity and mortality.

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