RESUMEN
AIM: To review the literature on lithotomy-related neurovascular complications (LRNVC) of the lower limbs after colorectal surgery. METHOD: Electronic databases were searched for relevant articles, including Medline, EMBASE, Pubmed, CENTRAL and CINHL. RESULTS: LRNVC after prolonged lithotomy position during colorectal surgery can be classified into vascular, neurological and neurovascular combined. Compartment syndrome (CS) is the most common clinical presentation. Seven case reports and 10 case series on 34 patients (27 men, 6 women) with CS have been reported. Risk factors included the lithotomy position and duration of surgery of more than 4 h. CONCLUSION: In colorectal surgery, lower limb LRNCVs, and CS are rare. A high index of clinical suspicion and early decompression may reduce morbidity.
Asunto(s)
Síndromes Compartimentales/diagnóstico , Posicionamiento del Paciente/efectos adversos , Complicaciones Posoperatorias/diagnóstico , Colon/cirugía , Síndromes Compartimentales/etiología , Síndromes Compartimentales/prevención & control , Síndromes Compartimentales/terapia , Humanos , Extremidad Inferior , Síndromes de Compresión Nerviosa/diagnóstico , Síndromes de Compresión Nerviosa/etiología , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Complicaciones Posoperatorias/terapia , Recto/cirugíaRESUMEN
A 45-year-old woman underwent microdiscectomy for sciatalgia due to prolapsed intravertebral disc between the fifth lumbar and first sacral vertebrae. Post-operatively, she developed abdominal pain and tenderness. Abdominal computerised tomography scan showed evidence of small bowel perforation. She underwent laparotomy and repair of an iatrogenic small bowel injury of the proximal ileum. Small bowel perforation is a rare complication of microdiscectomy and should be considered if abdominal symptoms develop post-operatively.