Small Bowel Perforation as a Postoperative Complication from a Laminectomy

Krieger, Robert H.; Wójcicki, K; Berry, Andrew C.; Reuther, Warren L.; McArthur, Kendrick D.

doi:10.1155/2015/378218

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…Given the low incidence rates of bowel injury, there is a paucity of reports in the literature examining details of bowel perforations following anterior approaches to the lumbar spine, with most of the literature consisting of case reports. 25 -31 The often-unclear clinical symptoms (abdominal tenderness and bloating) can lead to a diagnostic delay resulting in severe sepsis. 25,32…”

Section: Introductionmentioning

confidence: 99%

“…[11][12][13][14][15][16][17][18][19][20][21][22][23][24] Given the low incidence rates of bowel injury, there is a paucity of reports in the literature examining details of bowel perforations following anterior approaches to the lumbar spine, with most of the literature consisting of case reports. [25][26][27][28][29][30][31] The oftenunclear clinical symptoms (abdominal tenderness and bloating) can lead to a diagnostic delay resulting in severe sepsis. 25,32 We seek to build on the extant literature by examining our experience with this rare complication of anterior approaches to the lumbar spine to enhance the surgeon's awareness of its presentation and management.…”

Section: Introductionmentioning

confidence: 99%

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Iatrogenic Bowel Injury Following Minimally Invasive Lateral Approach to the Lumbar Spine: A Retrospective Analysis of 3 Cases

Rustagi

Yılmaz

Alonso

et al. 2018

Global Spine Journal

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Study Design: Retrospective cohort study. Objective: Anterior approaches are often used during lumbar interbody fusion procedures. Visceral injuries (bowel injuries) are rare but represent a primary risk during anterior approaches to the lumbar spine. Left untreated, these injuries can result in significant complications. The aim of this study was to investigate the presentation and management of bowel injury cases following anterior approaches to the lumbar spine to raise the surgeon’s awareness of this rare complication. Methods: All direct anterior, oblique anterior, and transpsoas lumbar interbody fusion surgeries performed at our institution between 2012 and 2016 were analyzed retrospectively. Charts were screened for cases requiring return to the operating room owing to a suspected bowel injury and details of the case were extracted for illustrative purposes. Results: A total of 775 anterior lumbar surgeries were conducted at a single tertiary care institution between July 2012 and June 2017. A total of 590 transpsoas lumbar interbody fusion (TPIF) surgeries were performed. Four patients, each having undergone TPIF, were suspected of bowel injury and underwent an exploratory laparotomy. At surgery, 3 patients were confirmed to have a bowel injury, giving a procedure-specific incidence of 0.51% and overall incidence of 0.39%. Among the 3 confirmed bowel injury cases, average delay between surgery and visceral injury diagnosis was 4.7 days (range 3-7 days). Conclusions: We noted abdominal pain, distention, and fever as the most common findings in the setting of a visceral injury. A high index of suspicion and computed tomography imaging remain critical for identifying postoperative bowel injuries.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Iatrogenic Bowel Injury Following Minimally Invasive Lateral Approach to the Lumbar Spine: A Retrospective Analysis of 3 Cases

Rustagi

Yılmaz

Alonso

et al. 2018

Global Spine Journal

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“…In this retrospective study, 13 out of the 24,026 patients that underwent elective spine surgeries; thus, the incidence was 0.054%. Some authors have reported cases of small bowel perforations following lumbar laminectomy or discectomy [ 18 , 19 ]. The authors considered that ventral hollow organ perforation is a rather rare complication of lumbar decompression surgery, andthe incidence of ventral hollow organ perforationis lower after laminectomy than discectomy.…”

Section: Discussionmentioning

confidence: 99%

Early detection and intervention for acute perforated peptic ulcer after elective spine surgeries: a review of 13 cases from 24,026 patients

Lin

Chuang

Kao

et al. 2021

BMC Musculoskelet Disord

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Background To determine how perforated peptic ulcers be diagnosed earlier after patients undergoing an elective spine surgery. Methods Patients who underwent elective spine surgeries at our hospital between January 2000 and April 2018 and experienced an acute perforated peptic ulcer were included. An age-and gender-matched control group was comprised of 26 patients without a postoperative acute perforated peptic ulcer who received spine surgery during the same period. Medical records and imaging studies were thoroughly reviewed. Results Thirteen patients were enrolled in the study group, including eight females and five males. Three patients, two females and one male, died of uncontrolled peritonitis during the hospital stay. All patients in the study group experienced the sudden onset of abdominal pain, which was continuous and progressively worsening. Patients with elevated serum amylase, a peptic ulcer history and increased intraoperative blood loss had a tendency to develop a postoperative perforated peptic ulcer. Conclusion Spine surgeons should be highly alert to these risk factors of postoperative perforated peptic ulcers inpatients who has history of peptic ulcer, large amount ofintraoperative blood loss and abnormal high serum amylase level after elective spine surgery. Early diagnosis and emergent surgical intervention promote better outcomes.

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“…In this retrospective study, 13 out of the 24,026 patients that underwent elective spine surgeries; thus, the incidence was 0.054%. Some case reports have reported the presence of small bowel perforations after lumbar laminectomy or discectomy [20,21]. The authors considered that ventral hollow organ perforation was a rather rare complication of lumbar decompression surgery, and laminectomy had a lower incidence than discectomy.…”

Section: Discussionmentioning

confidence: 99%

Early Detection and Intervention for Acute perforated Peptic Ulcer after Elective Spine Surgeries: A Review of 13 Cases from 24,026 Patients

Kao

Lin

Chiu

et al. 2021

Preprint

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Background:To determine how perforated peptic ulcers be diagnosed earlier after patients undergoing an elective spine surgeryMethods:Patients who underwent elective spine surgeries at our hospital between January 2000 and April 2018 and experienced an acute perforated peptic ulcer were included. An age-and gender-matched control group was comprised of 26 patients without a postoperative acute perforated peptic ulcer who received spine surgery during the same period. Medical records and imaging studies were thoroughly reviewed.Results:Thirteen patients were enrolled in the study group, including eight females and five males. Three patients, two females and one male, died of uncontrolled peritonitis during the hospital stay. All patients in the study group experienced the sudden onset of abdominal pain, which was continuous and progressive. Patients with elevated serum amylase, a peptic ulcer history and increased intraoperative blood loss had a tendency to develop a postoperative perforated peptic ulcer. Conclusion:Spine surgeons should be highly suspicious of a perforated peptic ulcer if a patient with abnormal high serum amylase level, a history of peptic ulcer and nonsteroidal anti-inflammatory druguse experiences, progressive pain in the epigastrium accompanied by abdominal rigidity and absent bowel sounds. Early diagnosis and emergency surgical intervention promote better outcomes.

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Small Bowel Perforation as a Postoperative Complication from a Laminectomy

Cited by 4 publications

References 17 publications

Iatrogenic Bowel Injury Following Minimally Invasive Lateral Approach to the Lumbar Spine: A Retrospective Analysis of 3 Cases

Iatrogenic Bowel Injury Following Minimally Invasive Lateral Approach to the Lumbar Spine: A Retrospective Analysis of 3 Cases

Early detection and intervention for acute perforated peptic ulcer after elective spine surgeries: a review of 13 cases from 24,026 patients

Early Detection and Intervention for Acute perforated Peptic Ulcer after Elective Spine Surgeries: A Review of 13 Cases from 24,026 Patients

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