Delayed right external iliac artery disruption after radical cystectomy: A case report and literature review

Abstract

A 60-year-old male patient underwent laparoscopic radical cystectomy with bilateral pelvic lymph node dissection and urinary diversion as a treatment for muscle-invasive bladder cancer and was discharged two weeks later. One month later, the patient was readmitted with septic and haemorrhagic shock, and was diagnosed with right external iliac artery disruption. The patient underwent an exploratory operation and a vessel split of the right external iliac artery was found. The artery split was covered by a vascular stent. Klebsiella pneumoniae subsp. Pneumoniae was isolated in blood culture and the patient then received adequate antibiotics based on the drug sensitivity test. The patient eventually had a good recovery and was discharged five weeks later. In summary, although iliac artery injury after successful pelvic surgery is a rare event, this life-threatening complication should be taken into full consideration, particularly in patients with high-risk factors such as diabetes mellitus.