Late Surgical Treatment of Iatrogenic Femoral Vein Ligation During Open Inguinal Hernia Repair

Abstract

Vascular complications during inguinal hernia repair are rarely seen; however, iliac vein ligation may be performed by the inexperienced surgeon. Here, we present a case of iatrogenic external iliac vein ligation diagnosed and surgically treated about one day after surgery. A 58-year-old male patient with bilateral inguinal hernia underwent open bilateral inguinal hernia repair. On the first postoperative day, severe edema, increased warmth and pain of the right leg developed. Duplex ultrasonography (USG) examination of the right lower extremity revealed acute thrombosis of deep veins. The patient was taken to vascular surgery about 24 hours after the inguinal hernia repair operation. It was detected that the right external iliac vein had been ligated iatrogenically during the initial operation. It was repaired with a duplicated saphenous vein patch. The diameter of the right leg decreased dramatically early after operation. The patient was discharged on the 3rd day postoperatively. On follow-up, the patient’s complaints regressed dramatically; we did not observe any complications and at six months, computerized tomography venography showed absence of stenosis of iliac vein. Major vascular complications after inguinal hernia repair operations must be kept in mind because of close proximity of the surgical area to main vascular structures. The surgical treatment of deep vein thrombosis after ligation of the iliac vein provides an efficient and quick repair if proper surgical techniques are used.

Keywords

• deep vein thrombosis
• saphenous patchplasty
• surgery
• inguinal hernia repair