Korean J Anesthesiol.  2011 Oct;61(4):336-340. 10.4097/kjae.2011.61.4.336.

Epidural hematoma occurred by massive bleeding intraoperatively in cesarean section after combined spinal epidural anesthesia: A case report

• Chung JH
• Hwang J
• Cha SC
• Jung T
• Woo SC

• KMID: 1766777
• DOI: http://doi.org/10.4097/kjae.2011.61.4.336

Abstract

We describe a case of acute lumbar epidural hematoma at the L2-3 level complicated by paraplegia, which occurred after coagulation disorder because of massive bleeding intraoperatively in cesarean section. The preoperative coagulation laboratory finding was in normal range and so we tried combined spinal epidural anesthesia. Uterine atony occurred in the operation, and there was persistant bleeding during and after the operation. After the operation, she complained of paresthesia on her both legs and was diagnosed with epidural hematoma (EDH) by radiologic examination. Emergency laminectomy on lumbar spine was carried out for hematoma evacuation and decompression of the epidural space at once. In our experience, massive bleeding during surgery may potentially increase the risk of EDH postoperatively.

Keyword

Blood coagulation disorder; Cesarean section; Epidural anesthesia; Epidural hematoma; Postpartum hemorrhage; Spinal anesthesia

MeSH Terms

Anesthesia, Epidural
Anesthesia, Spinal
Blood Coagulation Disorders
Cesarean Section
Decompression
Emergencies
Epidural Space
Female
Hematoma
Hemorrhage
Laminectomy
Leg
Paraplegia
Paresthesia
Postpartum Hemorrhage
Pregnancy
Reference Values
Spine
Uterine Inertia