Spinal cord infarction following surgery for mesenteric vascular occlusion

We present a case of spinal cord infarction following an operation on a 64-year-old man for mesenteric vascular occlusion under combined general and epidural anesthesia. Several etiological factors, each one able to affect blood flow in the spinal cord and cause infarction, might have been present in our patient, including generalized degenerative atherosclerotic vascular disease, secondary polycythemia resulting from the patient's chronic obstructive pulmonary disease, and intraoperative hypotensive episodes. This case shows that, even with careful technique, hemodynamic monitoring, and early evaluation of neurologic status, patients can experience irreversible spinal cord ischaemia that results in permanent paraplegia.