Vascular complications after inguinal hernia repair have been well documented. To our knowledge, all previously reported cases have been due to direct injury or compression of the vessels during the repair. We present the first case of thrombosis of the left common iliac artery after inguinal herniorrhaphy that was not due to direct injury or compression of the artery. Special coagulation testing revealed that the patient was a heterozygous carrier of the factor V R506Q (Leiden) mutation. This mutation is the most common cause of familial thrombophilia (hypercoagulable disorder) and is a known risk factor for venous thromboembolism. However, the association of this mutation with arterial thrombosis is less certain. Patients with thrombosis of the iliofemoral artery or vein after inguinal herniorrhaphy should be considered for special coagulation testing because of potentially important differences in anticoagulant treatment of the affected patient and for genetic counseling of potentially affected family members.
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