title: Transient bladder and fecal incontinence following epidural blood patch.
abstract: Epidural blood patch (EBP) is the currently accepted treatment of choice for postdural puncture headache because of its high initial success rates and infrequent complications. Many authors recommended a small volume (10-20 mL) of blood to be delivered for an effective EBP. Here, we report an obstetric patient who developed a transient bladder and fecal incontinence after 19 mL of blood EBP at L1 -L2 level. Since the magnetic resonance image did not demonstrate any definitive spinal cord lesion, the exact mechanism remains unclear. We suggest that accumulation of blood performed at L1 to L2 level in a closed relationship with the sacral cord, may have trigger a significant pressure elevation of the epidural space at this level, resulting in a temporal spinal cord-related injury in the sacral cord.
authors.affiliation: Department of Anesthesiology, Grupo HM Hospitales, Madrid, Spain.
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Palomero-Rodríguez
authors.affiliation: Department of Anesthesiology, Grupo HM Hospitales, Madrid, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Palacio-Abinzada
authors.affiliation: Department of Anesthesiology, Grupo HM Hospitales, Madrid, Spain.
authors.forename: Sara Chacón
authors.initials: SC
authors.lastname: Campollo
authors.affiliation: Department of Anesthesiology, Mostoles University Hospital, Madrid, Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Laporta-Báez
authors.affiliation: Department of Radiology, Ramón y Cajal University Hospital, Madrid, Spain.
authors.forename: Jose Carlos
authors.initials: JC
authors.lastname: Mendez Cendón
authors.affiliation: Department of Anesthesiology, Grupo HM Hospitales, Madrid, Spain.
authors.forename: Andres
authors.initials: A
authors.lastname: López-García
keywords: Complications; epidural anesthesia; epidural blood patch; magnetic resonance imaging; obstetric anesthesia; postdural puncture headache