[Massive hemorrhage following multiple epidural punctures as a late complication in thrombocythemia]

We present a female patient in whom numerous lumbar punctures for epidural anaesthesia were followed by a delayed development of a large subcutaneous haematoma in the lumbar region. The outcome was fatal. The patient's basic disease was found to be chronic myeloic leukaemia that had caused an excessive elevation of platelet count. We, therefore, suggest that lumbar punctures for epidural anaesthesia should be approached with extreme care in cases of thrombocytaemia. If possible, repeated punctures for the placement of epidural catheters should be avoided.