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Related Experiment Videos

Paraspinal abscess associated with epidural in labour

V Raj1, J Foy

  • 1Department of Anaesthesia, National Women's Hospital, Auckland, New Zealand.

Anaesthesia and Intensive Care
|September 23, 1998
PubMed
Summary

A woman developed serious neurological symptoms after an epidural due to a previously undetected paraspinal abscess. This case highlights the importance of considering unusual causes for complications following epidural anesthesia.

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Area of Science:

  • Obstetrics and Gynecology
  • Neurology
  • Anesthesiology

Background:

  • A 24-year-old woman with diagnosed pelvic arthropathy received an epidural for labor and underwent an instrumental delivery.
  • The patient was discharged home following an uneventful procedure.

Observation:

  • The patient re-presented 19 days postpartum with left hip pain and new-onset lower limb neurological deficits.
  • Magnetic Resonance Imaging (MRI) revealed a large paraspinal abscess compressing the spinal cord via an epidural granulation mass.

Findings:

  • Urgent surgical decompression was performed to alleviate spinal cord compression.
  • The paraspinal mass was likely present at the time of the initial epidural insertion, though undiagnosed.

Implications:

  • This case underscores the critical need to consider rare and atypical etiologies when evaluating complications after neuraxial anesthesia.
  • Diagnostic vigilance is paramount, as seemingly routine procedures can mask or be complicated by underlying, occult pathologies.

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