Rapid development of a spinal epidural hematoma following thoracic epidural catheter removal in an esophageal carcinoma surgical patient: a case report

JA Clinical Reports
Takeshi UmegakiTakahiko Kamibayashi

Abstract

The occurrence of spinal epidural hematomas associated with the use of epidural catheters is relatively rare. Furthermore, it is unusual for hematoma-associated neurological symptoms to occur within 15 min of removing a catheter. Here, we report our experience with an esophageal carcinoma surgical patient who developed an epidural hematoma almost immediately after catheter removal, resulting in paralysis of his lower extremities. The patient achieved full neurological recovery following prompt diagnosis and surgical intervention. A 68-year-old man was admitted with esophageal carcinoma and underwent video-assisted thoracoscopic esophagectomy followed by posterior mediastinal gastric tube reconstruction. During surgery, the patient was administered both general and epidural anesthesia. The epidural catheter was inserted approximately 5 cm into the epidural space at the Th6-7 level. The patient was extubated the following day in the general intensive care unit. Two days after surgery, the d-dimer level was high at 36.9 μg/mL (reference range 0-0.9 μg/mL), and we decided to administer an anticoagulant (enoxaparin sodium) to prevent thrombosis. The epidural catheter was removed 2 h prior to the scheduled administration of enoxapari...Continue Reading

References

Dec 1, 1996·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·H Wulf
Jan 10, 2003·Neurosurgical Review·D KreppelW Seeling
May 13, 2003·Respiration; International Review of Thoracic Diseases·Guy MeyerOlivier Sanchez
Aug 14, 2010·Anesthesia and Analgesia·Shuang-Ling LiDaqing Ma
Feb 16, 2016·Acta Anaesthesiologica Scandinavica·E B Rosero, G P Joshi
May 24, 2016·Indian Journal of Anaesthesia·Sudeep MahapatraSurjya Prasad Upadhyay

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Citations

Nov 22, 2018·Nursing·Monakshi SawhneyFeliks Hysi

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