Epidural abscess secondary to the implantation of a thoracic catheter
Rama-Maceiras, P.; Bonome, C.; Alvarez-Refojo, F.; Ferreira, T.A.; Fraga, M.; Pose, P.
Revista Espanola de Anestesiologia y Reanimacion 45(4): 153-155
1998
ISSN/ISBN: 0034-9356 PMID: 9646656 Document Number: 490924
Spinal compression related to the formation of an epidural abscess after epidural blockade is a rare but serious complication. We report the case of a male patient in whom a thoracic epidural catheter was implanted to provide analgesia after trauma involving fracture ribs. The patient developed an epidural abscess within one week of implantation. Delay in diagnosis led to persistent neurogenic bladder symptoms in spite of aggressive treatment. We review causal factors, mechanisms of formation, pathogenesis, diagnosis and management, as well as possible relation between injury and abscess formation. We also emphasize the importance of adequate vigilance as well as rapid diagnosis and adoption of therapeutic measures in order to avoid permanent sequelae such as paresis, sensory deficits or mechanical sphincter dysfunction.