Considerations for Iliac Vein Repair in the Setting of Urologic Procedures

Introduction: Iliac vein injuries are associated with high morbidity and mortality, with a feared complication of hemorrhage. We discuss management and the thought process behind mitigating such emergencies. Case presentation: An 81-year-old Caucasian male was seen intraoperatively by vascular surgery for hemorrhage from an injured left external iliac vein in the setting of left radical nephrectomy and ureterectomy. Conclusion: Despite initial temporizing efforts by urology, vascular surgical intervention proved necessary in hemostasis, venous reconstruction, and thus, establishing continuity of lower extremity venous drainage.