Post-laminectomy arteriovenous fistula with initial presentation as acute tubular necrosis. |
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| Authors: | Steven W Fineman James L Bailey |
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| Affiliation: | Department of Medicine, Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL 35294, USA. stevefineman@hotmail.com |
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| Abstract: | | Introduction | Nephrologists commonly see acute tubular necrosis (ATN) in thepost-operative setting. We report a case of ATN complicatinglumbar laminectomy surgery, which is unique because the aetiologyof the ATN was later discovered when the patient presented withhigh-output congestive heart failure. An arteriovenous fistulabetween the iliac artery and iliac vein explained both the patientsacute presentation and subsequent high output heart failure. Case | A 36-year-old previously healthy female underwent elective lumbarlaminectomy at an outside hospital for a documented disc herniationat the L4L5 vertebral level sustained at work. The patienthad no significant past medical history and was taking onlyan oral contraceptive. Her social and family histories wereunremarkable. The patient had a stormy post-operative course, which was markedinitially by persistent tachycardia and nausea. A pulmonary
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| Keywords: | acute renal failure acute tubular necrosis arteriovenous fistula congestive heart failure surgery |
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