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Masui. 1998 May;47(5):593-5.

[Epidural hematoma associated with epidural catheterization in a cirrhotic patient].

[Article in Japanese]

Author information

  • 1Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College.

Abstract

We present a case of epidural hematoma in a liver cirrhosis patient with a depressed platelet count but normal prothrombin and activated thromboplastin times. A 60-year-old woman hospitalized with liver cirrhosis was referred to us for low back pain. She suffered the fracture of the body of the 12 th thoracic vertebra in a fall. Her platelet count was below normal ranges, but, other coagulation tests were within normal ranges. We inserted an 18-gauge epidural catheter at Th 12-L1 interspace. Twenty-one days later, paresis and hypesthesia in both legs, and a loss of sphincter function occurred. Magnetic resonance imaging revealed a posteriorly placed hematoma extending from Th 12 to L1. Considering the hemorrhagic tendency and hepatic insufficiency, we did not perform laminectomy. After 4 days, the patient's strength began to recover, and after 7 days paresis and hypesthesia improved. We should avoid performing epidural catheterization to improve chronic pain for a patient with liver cirrhosis if his or her platelet count is below 100,000.mm-3.

PMID:
9621671
[PubMed - indexed for MEDLINE]
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