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Korean J Anesthesiol > Volume 37(6); 1999 > Article
Korean Journal of Anesthesiology 1999;37(6):1139-1142.
DOI: https://doi.org/10.4097/kjae.1999.37.6.1139   
Postoperative Epidural Fibrosis: An Erroneous Diagnosis as Epidural Abscess after Epidural Block: A case report.
Yung Gil Choi, Min Jung Kim, Jung Ae Lim, Kyu Chang Lee, Nam Sik Woo, Ye Chul Lee
Department of Anesthesiology, College of Medicine Konkuk University, Seoul, Korea.
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.
Key Words: Complication, epidural abscess, epidural fibrosis
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