[Hemorrhagic shock caused by rupture of the iliac vein. A very rare complication of hip arthroplasty]. / Shock hemorrágico por rotura de vena ilíaca. Una complicación muy rara en las artroplastias de cadera.

ABSTRACT

We report the case of a 51 years old woman who underwent replacement of a total prosthesis of the right hip under general anesthesia and during left lateral decubitus. During the surgical procedure we observed signs of hemorrhagic shock and a concealed bleeding was suspected. After a diagnostic peritoneal puncture we performed a midlaparotomy which revealed a large retroperitoneal hematoma produced by rupture of the right internal iliac vein. Reanimation of the patient included a massive transfusion of 28 units of blood. We analyze the mechanisms of this rare complication which occurs during total arthroplasty of the hip. We recommended routine monitoring of the central venous pressure in this type of surgery since it is associated with large blood losses.