Korean J Anesthesiol.  1999 Dec;37(6):1139-1142. 10.4097/kjae.1999.37.6.1139.

Postoperative Epidural Fibrosis: An Erroneous Diagnosis as Epidural Abscess after Epidural Block: A case report

• Choi YG
• Kim MJ
• Lim JA
• Lee KC
• Woo NS
• Lee YC

• KMID: 2031468
• DOI: http://doi.org/10.4097/kjae.1999.37.6.1139

Abstract

The epidural abscess, while rare, should be taken seriously, as it can result in permanent neurological complications. Fever, back pain, leukocytosis and elevation of Erythrocyte Sedimentation Rate (ESR) are major signs and symptoms of epidural abscesses. But clinical recognition of such abscesses may be very difficult because of nonspecific symptoms or signs as well as previous or underlying painful disorders. Few cases has been reported of epidural abscess and epidural fibrosis associated with back surgery or temporary epidural blocks. In these cases, however, fever, low back pain, sciatica and elevation of ESR were the major findings. Magnetic Resonance Imaging findings after Gadolinium- diethylenetriaminopenta-acetic acid (Gd-DTPA) enhancement show central low signal intensity and surrounding high signal intensity at the anterior epidural space between the 5th lumbar and 1st sacral vertebrae. We suspected an epidural abscess caused by epidural block, and so operated. But our operative finding was epidural fibrosis without abscess. Our final pathological diagnosis was epidural fibrosis.

Keyword

Complication, epidural abscess, epidural fibrosis

MeSH Terms

Abscess
Back Pain
Blood Sedimentation
Diagnosis*
Epidural Abscess*
Epidural Space
Fever
Fibrosis*
Leukocytosis
Low Back Pain
Magnetic Resonance Imaging
Sciatica
Spine