An infected fistula following a peridural catheter
Schregel, W.; Hartmann, K.; Schmitz, C.; Baumgärtner, D.; Cunitz, G.
Der Anaesthesist 41(6): 346-347
1992
ISSN/ISBN: 0003-2417 PMID: 1636919 Document Number: 400618
An infected fistula was observed in a woman (Age: 69 years, weight: 60 kg, height: 159 cm) 14 days after insertion and 8 days after removal of a peridural catheter inserted preoperatively for postoperative analgesia after nephrectomy (carcinoma). Due to haemodynamic problems in the early postoperative period no analgetic or local anaesthetic medication was applied via the peridural catheter. After unsuccessful antibiotic and surgical treatment the women was transferred to the Neurosurgical department five weeks after nephrectomy. Magnetic resonance imaging of the lumbar region showed a fistula (Segment L2/L3) reaching the epidural space but no epidural spreading or epidural abscess. Partial laminectomy L2/L3 was performed and the fistula excised under continuous antibiotic treatment with ofloxacin. Up until 21 months after the operation no recidivation occurred. Exact details of catheter insertion and catheter treatment in the postoperative period are not available; the fact, that no bactericide [9] local anaesthetic agents were applied, might have favoured the occurrence of this infection. Infectious complications have to be taken into consideration for the indication of peridural catheters in the perioperative period.