Oxidised regenerated cellulose: an unusual cause of paraplegia following oesophagectomy.
Oesophageal resection after neoadjuvant therapy is the treatment of choice in localized oesophageal cancer. Common complications after oesophagectomy include pulmonary infection and anastomotic leaks. Paraplegia or paraparesis after oesophagectomy is an extremely uncommon occurrence and has not been reported in medical literature. Possible causes include injury to the spinal cord due to epidural catheter insertion, epidural haematoma and anterior spinal artery thrombosis. Pressure on the spinal cord due to migrated oxidised regenerated cellulose (ORC) is an extremely rare cause. Meticulous haemostasis at the costovertebral angle with a combination of pressure and electrocautery is advocated to prevent this rare but catastrophic complication. We describe a middle aged woman who developed post-thoracotomy paraplegia following ORC compression on the spinal cord.
Department of Bioimaging, Tata Memorial Hospital, Mumbai 400012, India.
Sumeet
S
Dua
Nilendu C
NC
Purandare
Nikhil H
NH
Merchant
C S
CS
Pramesh
D002483:Cellulose, Oxidized / Q000009:adverse effects* / Q000627:therapeutic use; D019299:Decompression, Surgical / Q000379:methods; D018450:Disease Progression; D004638:Emergency Treatment; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods*; D017809:Fatal Outcome; D005260:Female; D006488:Hemostasis, Surgical / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007796:Laminectomy / Q000379:methods; D008875:Middle Aged; D010264:Paraplegia / Q000139:chemically induced* / Q000503:physiopathology / Q000601:surgery; D053717:Pneumonia, Ventilator-Associated / Q000175:diagnosis / Q000628:therapy; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy; D012121:Respiration, Artificial / Q000009:adverse effects; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods
D002483:Cellulose, Oxidized