Surgical mystery: where is the missing pituitary rongeur tip?

Spine
Ali BydonReza Yassari

Abstract

Case report. We report the unusual case of a patient who was referred to our institution after she sustained an intraoperative injury to the common iliac vein during posterior lumbar discectomy at L5-S1 with a pituitary rongeur. There was only minimal bleeding with spontaneous hemostasis and no hemodynamic instability. Subsequently, the referring surgeon noted that the pituitary rongeur tip was missing. Vascular injury during lumbar discectomy is a rare, but potentially devastating complication. Rapid diagnosis and treatment is traditionally targeted toward hemodynamic stabilization and repair of compromised structures. Intraoperative fluoroscopy confirmed the presence of the tip anterior to the L3 vertebral body, indicating a possible intravascular migration of the foreign body. After completion of the surgical procedure, an abdominal computed tomography scan failed to confirm the metallic object within the abdominal cavity. Subsequent imaging studies demonstrated the presence of the rongeur tip in the left ventricle. Transthoracic echocardiogram and cardiac catheterization confirmed the presence of a patent foramen ovale and localized the rongeur tip within the papillary cords of the left ventricle, in close proximity of the ...Continue Reading

References

Sep 1, 1979·Archives of Surgery·D C BrewsterA C Moncure
Apr 1, 1978·The Journal of Trauma·N M RichJ J Ricotta
Jun 1, 1991·British Journal of Anaesthesia·B Ewah, I Calder
Dec 1, 1989·AJR. American Journal of Roentgenology·J J KellyR J Waite
Oct 1, 1987·The Journal of Trauma·F L ShannonF A Moore
Jan 1, 1972·Acta Orthopaedica Scandinavica. Supplementum·E V Spangfort
Jan 1, 1971·Acta neurochirurgica·T Grumme, B Bingas
Nov 1, 1993·Spine·J K BakerM H Heggeness
Jul 1, 1996·The Annals of Thoracic Surgery·S K GandhiJ E Mazuski
Oct 1, 1996·American Heart Journal·M Mollod, J M Felner
Aug 1, 1996·Neuroradiology·D H SzolarD Norman
Jan 1, 1996·Acta neurochirurgica·J FruhwirthG Flaschka
Jun 10, 1998·The Journal of Bone and Joint Surgery. British Volume·M TanakaM Tanizaki
Mar 9, 2000·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·S J FryE M Isselbacher
Apr 25, 2000·Journal of Clinical Anesthesia·J L HanouzH Bricard
Sep 10, 2002·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·S PapadoulasJ A Tsolakis
Apr 24, 2003·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Peter FritzellUNKNOWN Swedish Lumbar Spine Study Group
Aug 21, 2003·The Journal of Thoracic and Cardiovascular Surgery·Guglielmo Maria Actis DatoEnrico Ruffini
Sep 1, 1953·Journal of Neurosurgery·M E LEAVENS, F K BRADFORD
Sep 1, 1954·Annals of Surgery·S P HARBISON
Mar 1, 1959·Journal of Neurosurgery·R L DESAUSSURE
Mar 1, 1961·The Journal of Trauma·E S GURDJIANL M THOMAS
Jul 1, 1962·The British Journal of Surgery·H TAYLOR, E WILLIAMS
Dec 13, 2003·Annals of Vascular Surgery·Tae-Won KwonGeun-Eun Kim
Dec 14, 2004·Vascular and Endovascular Surgery·Enrico AscherS Salles-Cunha
Dec 3, 2005·Acta neurochirurgica·J Inamasu, B H Guiot
Jan 18, 2006·Clinical Neurology and Neurosurgery·Murat DöşoğluK Hakan Yildiz
May 9, 2008·Annals of Vascular Surgery·Ching-Yang WuPo-Jen Ko
Sep 19, 2009·Interactive Cardiovascular and Thoracic Surgery·Pietro MarcelloJosé Manuel Méndez López

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Citations

Dec 28, 2010·Journal of Neurosurgery. Spine·Virginie LafageJean-Pierre Farcy
Mar 10, 2020·British Journal of Neurosurgery·Emine Seyma Denli Yalvac, Naci Balak
Jul 17, 2020·Curēus·Richard P MengerAnil Nanda

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