Epidural abscess after epidural catheter for pain release during pancreatitis.
BACKGROUND
Despite knowledge about compromised host defence in the course of diabetes mellitus and pancreatitis, epidural analgesia (EA) is recommended for pain management during pancreatitis.


METHODS
We present the case of a diabetic patient with pancreatitis who developed an epidural abscess after 3 days with an epidural catheter. Natural killer and T-helper cell counts were distinctively reduced in the absence of HIV serology. Furthermore, a synthesis failure of the liver was observed and evidenced by low cholinesterase, low whole protein fraction and low antithrombin III in the peripheral blood.


CONCLUSIONS
We suggest that the combination of pancreatitis, diabetes and compromised immunity might be a contraindication to epidural analgesia.
Heller
A R
AR
Department of Anaesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus, Dresden, Germany. heller-a@rcs.urz.tu-dresden.de
Ragaller
M
M
Koch
T
T
D000038:Abscess / Q000209:etiology*; D015360:Analgesia, Epidural / Q000009:adverse effects*; D048909:Diabetes Complications; D006407:Hematoma, Epidural, Cranial / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D059408:Pain Management; D010195:Pancreatitis / Q000150:complications*; D013122:Spinal Diseases / Q000209:etiology*; D014057:Tomography, X-Ray Computed