Retained Epidural Catheter Fragment Requiring Surgical Removal in a Patient With Multiple Comorbidities: A Case...

Epidural analgesia remains an important technique in many clinical settings; although generally considered safe, it is not free of complications. We present the case of a 69-year-old woman with poorly controlled diabetes mellitus and hypertension who, during an epidural block for a left open hepatectomy, experienced the fracture and retention of a 10-cm epidural catheter fragment within the spinal canal at the T12-L1 level. Despite the patient being asymptomatic, surgical removal was required due to the fragment's location and length and the potential risk of long-term systemic complications associated with her comorbidities. Among the main causes of catheter retention, excessive traction during removal is one of the most frequently reported mechanisms. The management of a retained epidural catheter fragment depends on multiple variables, including fragment size, anatomical location, symptomatology, and patient comorbidities. While conservative management may be appropriate for selected asymptomatic patients with small fragments located outside the spinal canal, surgical extraction is recommended when the fragment is large, located within the spinal canal, and associated with an increased risk of infection or systemic complications or when the patient develops neurological symptoms.