Erosion of the inferior epigastric artery: a rare complication of intrathecal drug delivery systems.
Intrathecal baclofen is an invaluable therapeutic modality in the management of severe spasticity, especially in patients with cerebral palsy, multiple sclerosis, and spinal cord and brain injuries. This case report presents a rare complication of long-term intrathecal infusion with the development of a huge anterior abdominal wall hematoma with extension to the retroperitoneal space as a result of a repeated blunt trauma to the site of the intrathecal pump with erosion of the inferior epigastric artery. This inferior epigastric artery erosion could be avoided by implanting the intrathecal pump laterally away from the rectus abdominus muscle sheath.
Narouze
Samer N
SN
Pain Management Center, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. narouzs@ccf.org
Yonan
Sameh
S
Kapural
Leonardo
L
Malak
Osama
O
D000007:Abdominal Injuries / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D000009:Abdominal Muscles / Q000098:blood supply / Q000473:pathology; D034861:Abdominal Wall / Q000098:blood supply / Q000473:pathology; D001418:Baclofen / Q000008:administration & dosage*; D002408:Catheters, Indwelling / Q000009:adverse effects; D004621:Embolization, Therapeutic; D019074:Epigastric Arteries / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D018755:GABA Agonists / Q000008:administration & dosage; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000503:physiopathology; D007049:Iatrogenic Disease / Q000517:prevention & control; D015918:Infusion Pumps, Implantable / Q000009:adverse effects*; D007278:Injections, Spinal / Q000009:adverse effects / Q000295:instrumentation; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000188:drug therapy*; D011859:Radiography; D012187:Retroperitoneal Space / Q000473:pathology; D016896:Treatment Outcome
D018755:GABA Agonists; D001418:Baclofen