LOMBER DÝSK CERRAHÝSÝNDE MAJÖR VASKÜLER YARALANMALAR

Lomber disk cerrahisinde vasküler komplikasyonlar nadirdir. Ortaya çýkan komplikasyonlar akut ve kronik olarak ikiye ayrýlýrlar. Akut komplikasyonlar þok þeklinde daha ameliyat masasýnda kendini gösterirken, kronik belirtiler, pseudoanevrizmaya ait basý semptomlarý yada majör arteryo-venöz fistüle baðlý konjestif kalp yetmezliði þeklinde ortaya çýkabilir. 35yaþýnda bayan ve 24 yaþýndaki erkek hastalarýmýzda lomber disk cerrahisi sonrasý geliþen hemorajik þok tablosunda acil müdahalede bulunulurken 36 yaþýndaki bayan hastamýz lomber disk cerrahisi sonrasý 2. yýlda ortaya konan sað iliak arteryo-venöz fistül nedeniyle elektif þartlarda opere edilmiþlerdir. Vakalarýmýz halen sorunsuz takip edilmektedir. Majör damarlara baðlý komplikasyonlar ne kadar erken ortaya konulup cerrahi tedavisi yapýlýrsa mortalite de o ölçüde azalacaktýr. Lomber cerrahi geçirmiþ ve nedeni ortaya konamayan konjestif kalp yetmezliðinde majör A-V fistül araþtýrýlmalýdýr.

MAJOR VASCULAR COMPLICATIONS IN SURGERY OF LOMBER DISC

Vascular complications in surgery of lomber disc are very rare. These complications can be either acute or chronic. Acute complications like hemorrhagic shock can be seen peroperatively. Symptoms like pressure of pseudoanevrism or congestive cardiac failure because of major arterio-venous fistula can be seen at postoperative period. 35 year old female and 44 year old male patients had hemorrhagic shock symptoms after the surgery of lomber disc were reoperated in the early postoperative period. 42 year old male patient who had been operated 2 years before was reoperated because of iliac arterio-venous fistula. If major vascular complications can be recognised and treated early the mortality rate will be low. In patient who have congestive cardiac failure with a history of lomber disc surgery, major arterio-venous fistula should always be remembered in the differential diagnosis