Acute limb ischemia due to iliac thrombosis following laparoscopic surgery for hiatal hernia: Report from a medical malpractice litigation

Pasqualino Sirignano; Giuseppe Galiero; Ascanio Sirignano; Maurizio Taurino

doi:10.1016/j.amsu.2021.102505

Acute limb ischemia due to iliac thrombosis following laparoscopic surgery for hiatal hernia: Report from a medical malpractice litigation

Ann Med Surg (Lond). 2021 Jun 13:67:102505. doi: 10.1016/j.amsu.2021.102505. eCollection 2021 Jul.

Authors

Pasqualino Sirignano¹, Giuseppe Galiero², Ascanio Sirignano³, Maurizio Taurino⁴

Affiliations

¹ Department of Surgery "Paride Stefanini", "Sapienza" University of Rome, Italy, Vascular and Endovascular Surgery Division, Sant'Andrea Hospital of Rome, Italy.
² Legal Medicine Unit, Department of Advanced Biomedical Sciences, School of Medicine, "Federico II", University of Naples, Italy.
³ School of Law, Medico-Legal Section, University of Camerino, Italy.
⁴ Department of Clinical and Molecular Medicine, "Sapienza" University of Rome, Italy, Vascular and Endovascular Surgery Division, Sant'Andrea Hospital of Rome, Italy.

Abstract

Aim of this paper is to report an unusual case of iliac artery acute thrombosis following a laparoscopic elective surgery for hiatal hernia repair and observed during a medical malpractice litigation. A 69-year-old woman submitted to laparoscopic hiatal hernia repair developed a lower limb ischemia in 5th postoperative day due to common iliac and popliteal arteries acute occlusion. Patient was urgently treated with iliac embolectomy with Fogarty's catheter, and femoral endarterectomy, followed on 1st post-operative day by external iliac artery stenting and multiple attempts of popliteal artery recanalization. After 4 years of follow-up, despite symptoms at rest were disappeared, a severe (<200 m) right limb claudication was still present.

Keywords: Complications; Iliac artery thrombosis; Laparoscopic surgery; Litigation; Malpractice; Vascular surgery.

Publication types

Case Reports