Yaman ÖZYURT, Hakan ERKAL, Selda İTEZ, Hüsnü SÜSLÜ, Zuhal ARIKAN

Spinal anestezi uygulamasından sonra gelişen spinal-epidural apse (olgu sunumu)

Spinal-epidural apse (SEA), sıklıkla tanısı güç ve geç konulan, yüksek morbidite ve mortalite oranlarına sahip nadir, enfeksiyöz bir patolojidir. Bu makalede, spinal anestezi uygulanmasından sonra spinal-epidural apse tanısı konulan ve cerrahi tedavi uygulanan 71 yaşındaki hastayı sunduk. Ürolojik girişim nedeniyle operasyona alınan hastada, spinal anestezi, LİA aralığından, 22 G Quincke spinal iğne kullanılarak yapıldı. Spinal anestezi uygulanmasından yedi gün sonra, özellikle sağ tarafında belirgin olan sırt ağrısı yakınması başlayan hastaya, manyetik rezonans görüntüleme yöntemi ile spinal anestezi uygulanmasından 35 gün sonra spinal epidural apse tanısı kondu. Cerrahi tedavi uygulanmasından sonra, hata nörolojik sekel gelişmeden taburcu edildi. Pek çok klinik tabloyu taklit edebildiğinden, spinal anestezi sonrası sırt ağrısı olan hastalarda, spinal epidural apse ayırıcı tanıda akılda bulundurulmalıdır.

Anahtar Kelimeler:

Erkek, Manyetik rezonans görüntüleme, Anestezi, spinal, Yaşlı, Apse, Anestezi, epidural, Epidural apse

Spinal epidural abscess following spinal anesthesia (case report)

Spinal epidural abscess is a rare infectious disorder, often with a delayed diagnosis, and associated with significant morbidity and mortality rates. We report a case of lumbar epidural abscess following spinal anaesthesia for transurethral resection of the prostate in a 71-year-old patient. Spinal anesthesia was performed in L3.4 inter space by using 22 G Quincke needle. Seven days after spinal anesthesia, patient suffered from lumbar backpain which was marked on right side. Spinal epidural abscess diagnosed 35 days after the anesthesia with magnetic resonance imaging. After surgical removal of the spinal abscess our patient discharged from the hospital without neurological sequellae. The clinical picture of spinal epidural abscess can mimic many other conditions, and this lesion should ahvays be included in the differential diagnosis for backpain.

Keywords:

Male, Magnetic Resonance Imaging, Anesthesia, Spinal, Aged, Abscess, Anesthesia, Epidural, Epidural Abscess,

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