Small bowel entrapment as a rare complication of lumbar micro discectomy: Case report and literature review

TL;DR

A rare case of small bowel injury following a lumbar discectomy is reported, highlighting the importance of early diagnosis and surgical intervention to prevent severe complications.

Contribution

This case report adds to the limited literature on intestinal injury as a rare complication of lumbar disc surgery.

Findings

A 47-year-old male developed acute abdomen and small bowel entrapment after L5-S1 discectomy.

Segmental bowel resection and double ileostomy were required for treatment.

Early recognition and timely surgical intervention are crucial to prevent severe outcomes.

Abstract

Laminectomy with lumbar disc excision remains the standard surgical approach for the management of lumbar disc herniation. While the incidence and nature of common complications associated with this procedure are well-documented, ventral perforation leading to intestinal injury is an exceptionally rare occurrence. However, when it does occur, it can result in severe and potentially life-threatening consequences.

We present the case of a 47-year-old male who developed an acute abdomen on the second postoperative day following an L5-S1 discectomy. Exploratory laparotomy revealed small bowel entrapment. Surgical management included segmental resection of the affected bowel segment with the creation of a double ileostomy.

Although exceedingly rare, intestinal injuries secondary to ventral perforation during lumbar discectomy can have serious repercussions. Adequate preoperative surgical planning, careful selection of the surgical approach, and meticulous dissection are critical in minimizing the risk of ventral perforation and subsequent bowel injury.

Intestinal injury should be recognized as a potential but uncommon complication of lumbar disc surgery, particularly in patients presenting with acute abdominal symptoms or persistent wound infections postoperatively. Prompt diagnosis and timely surgical intervention are crucial in preventing severe morbidity and mortality.

•Bowel injury after lumbar discectomy is rare but can be fatal if unrecognized.•Early signs include acute abdomen or prolonged wound infection.•Imaging plays a crucial role in diagnostic•Early recognition and timely surgical intervention are essential.•Prevention is Crucial

Bowel injury after lumbar discectomy is rare but can be fatal if unrecognized.

Early signs include acute abdomen or prolonged wound infection.

Imaging plays a crucial role in diagnostic

Early recognition and timely surgical intervention are essential.

Prevention is Crucial

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