[Symptomatic epidural haematoma under therapeutic dose heparin: occurrence after removal of a peridural catheter].
A 55-year-old patient with severe arterial occlusive disease underwent a femoral artery bypass operation under combined spinal-epidural anaesthesia. Platelet count and coagulation tests were normal after phenprocoumon had been discontinued. The epidural catheter was removed on day 1 while the patient was under therapeutic dose heparin. On day 2 he complained about lower back pain going down both legs and tendon reflexes were absent on the left side. Computed tomography and magnetic resonance imaging showed a lumbar epidural haematoma, which together with a previously existing protrusion of the fourth lumbar disc, compressed the cauda equina. A neurosurgical consultation recommended a conservative approach. The symptoms resolved spontaneously and the patient was discharged in good condition 12 days after the operation.
Nitz
P
P
Klinik für Anaesthesiologie, St. Josef Hospital, Klinikum der Ruhr-Universität Bochum, Gudrunstr. 56, 44791 Bochum, Deutschland. petra.nitz@rub.de
Laubenthal
H
H
Haller
S
S
Mumme
A
A
Meiser
A
A
D000767:Anesthesia, Epidural; D000775:Anesthesia, Spinal; D000925:Anticoagulants / Q000009:adverse effects*; D001157:Arterial Occlusive Diseases / Q000601:surgery; D002404:Catheterization; D005263:Femoral Artery / Q000601:surgery; D046748:Hematoma, Epidural, Spinal / Q000139:chemically induced* / Q000175:diagnosis; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D012018:Reflex / Q000187:drug effects; D013117:Spinal Cord Compression / Q000150:complications / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D014656:Vascular Surgical Procedures
D000925:Anticoagulants; D006493:Heparin