We report an accident perforation of the left iliac artery and vein during
lumber discectomy in the kneeling position. During the surgical procedure,
a brief and transient hypotension occured, although the surgeon did not obs
erve any abnormal bleeding in the operating field. In the recovery room, ar
terial blood pressure decreased. and tachycardia, pallar, and abdominal pai
n occurred. Retroperitoneal bleeding was suspected. Immediate fluid rescuci
tation was initiated, anesthesia was continued, and red blood cells were or
dered. The use of medical antishock trousers enabled temporization until va
scular surgeons were ready. An emergent laparotomy was preformed to repair
vascular injuries. The delayed symptoms, use of medical antishock trousers,
and implications for anesthetists are discussed. (C) 2000 by Elsevier Scie
nce Inc.