Spinal epidural hematoma in a gastric cancer patient after epidural catheterization: A case report

Ryu, Jung Wan; Han, Jong In; Lee, Heeseung; Kim, Dong Yeon

Case Report

Spinal Pain

Anesthesia and Pain Medicine 2011;6(2):121-124.
Published online April 30, 2011.

Spinal epidural hematoma in a gastric cancer patient after epidural catheterization: A case report

Jung Wan Ryu, Jong In Han, Heeseung Lee, Dong Yeon Kim

Department of Anesthesiology and Pain Medicine, School of Medicine, Ewha Womans University, Seoul, Korea. kdyeon@ewha.ac.kr

Abstract

Spinal epidural hematoma is a rare event that is usually thought to require immediate surgical therapy. A variety of predisposing factors have been demonstrated for this malady and hemostatic abnormalities are rather frequent in cancer patients. In this report, we present a case of an old man who was diagnosed with early gastric cancer. He had normal coagulation function. After performing hemodynamically stable surgery, an epidural catheter was inserted. The patient underwent reoperation due to postoperative wound bleeding on postoperative day 1. In the evening of the 2nd postoperative day, emergency magnetic resonance imaging (MRI) revealed an epidural hematoma extending from T5 to T8. The patient's coagulation function became even worse. We thought that acute DIC had developed on the patient. Approximately 2 months later, he finally showed spontaneous clinical improvement.

Key Words: Epidural analgesia, Gastric cancer, Spinal epidural hematoma