External iliac vein injury during total hip arthroplasty: a case report

Ji Hyo Kim and Ji Hyun Kim contributed equally to this work and also co-first authors. Vascular injuries during total hip arthroplasty (THA) are rare, but they could be life threatening when they occurs. Therefore, early diagnosis and appropriate management should be required to reduce the rate of morbidity and mortality of the patient. In case of external iliac vein (EIV) injury, it could be more difficult to be noticed because of its slow onset, which could result in cata­ strophic, delayed hemorrhagic shock. Although EIV injury during THA is uncommon and has not been emphasized enough in anesthetic field, subsequence could be fatal. Herein, we report a case of EIV injury occurred by a drill tip passing through the acetabulum during THA. The patient showed an abrupt hemodynamic collapse without visual evidence of massive bleeding. Cardio­ pulmonary resuscitation was even required before detection and repair of EIV.