title: Spinal epidural hematoma after removal of an epidural catheter: case report and review of the literature.
abstract: We report a case of spinal epidural hematoma after removal of an epidural catheter. The patient had no background of anticoagulant therapy or coagulopathy; sudden severe back pain occurred immediately after removal of the catheter. The chance of this occurring is estimated to be between 1:150,000 and 1:190,000. We studied 40 previous reports from 1952 to 2000, and we also investigated anticoagulant therapy and pathologic states, puncture difficulties and bleeding at the point of insertion, and its onset. In 23 cases (57.5%), anticoagulant therapy had been performed, and in 5 cases (12.5%), coagulopathy or liver dysfunction had been recognized. In 20 cases (50%), the initial symptoms were recognized within 24 hours after removal of the epidural catheter. Although spinal epidural hematoma is a very rare condition, it is a serious complication of continuous epidural anesthesia.
authors.affiliation: Department of Orthopaedic Surgery, Oita Medical University, Oita, Japan. masashim@ceres.ocn.ne.jp
authors.forename: Masashi
authors.initials: M
authors.lastname: Miyazaki
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Takasita
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Matsumoto
authors.forename: Hironori
authors.initials: H
authors.lastname: Sonoda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsumura
authors.forename: Takehiko
authors.initials: T
authors.lastname: Torisu
mesh_terms: D000368:Aged; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D001416:Back Pain / Q000175:diagnosis / Q000209:etiology; D002404:Catheterization / Q000009:adverse effects*; D005260:Female; D046748:Hematoma, Epidural, Spinal / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D006801:Humans; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D014950:Wounds, Penetrating / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy