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Epidural abscess after epidural catheter for pain release during pancreatitis
A R Heller1, M Ragaller, T Koch
1Department of Anaesthesiology and Intensive Care Medicine, University Hospital Carl Gustav Carus, Dresden, Germany. heller-a@rcs.urz.tu-dresden.de
Background:
Despite knowledge about compromised host defence in the course of diabetes mellitus and pancreatitis, epidural analgesia (EA) is recommended for pain management during pancreatitis.
Case Report:
We present the case of a diabetic patient with pancreatitis who developed an epidural abscess after 3 days with an epidural catheter. Natural killer and T-helper cell counts were distinctively reduced in the absence of HIV serology. Furthermore, a synthesis failure of the liver was observed and evidenced by low cholinesterase, low whole protein fraction and low antithrombin III in the peripheral blood.
Conclusion:
We suggest that the combination of pancreatitis, diabetes and compromised immunity might be a contraindication to epidural analgesia.