Paraspinal abscess associated with epidural in labour.
A 24-year-old presented in labour requesting an epidural. She had been diagnosed as having "pelvic arthropathy" at 37 weeks. After an uneventful epidural and instrumental delivery, she discharged herself home. She re-presented 19 days later with left hip pain and abnormal neurological signs in the lower limbs. On MRI, there was a large paraspinal abscess with an epidural granulation mass compressing her spinal cord. She had an urgent surgical decompression. In hindsight, it is likely that the paraspinal mass was present at the time of epidural insertion. The discussion highlights that complications are sometimes not what they seem.
Raj
V
V
Department of Anaesthesia, National Women's Hospital, Auckland, New Zealand.
Foy
J
J
D000038:Abscess / Q000175:diagnosis* / Q000382:microbiology*; D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects*; D016362:Analgesia, Obstetrical / Q000009:adverse effects*; D019299:Decompression, Surgical; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000382:microbiology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology*; D014399:Tuberculosis, Spinal / Q000175:diagnosis*