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Article: Iatrogenic spinal epidural abscess

TitleIatrogenic spinal epidural abscess
Authors
KeywordsComplications
Epidural abscessa
Methicillin resistant Staphylococcus aureus (MRSA)
Spinal anesthesia
Issue Date2007
PublisherAmerican Chemical Society. The Journal's web site is located at http://www.belsurg.org/journal.html
Citation
Acta Chirurgica Belgica, 2007, v. 107 n. 2, p. 109-118 How to Cite?
AbstractBackground : Iatrogenic epidural abscess complicating neuro-axial blockade is rare, but carries significant morbidity and mortality if diagnosis is delayed. First documented in 1974, this disorder is now well described in the literature, and is increasing in incidence. Methods : A literature review was undertaken using Medline, all relevant papers on this rare, but important, complication of spinal epidural anesthesia or analgesia were used. Results : Widespread use of neuro-axial techniques in the peri-operative period such as epidural analgesia has probably contributed to improved surgical outcome but has also led to an increased incidence of complications. Epidural abscess or epidural catheter sepsis has previously been thought to occur rarely but recent publications suggest that it may be more frequent. Predisposing factors include old age, diabetes mellitus, alcoholism, cancer, and acquired immuno-deficiency syndrome. The signs and symptoms of epidural abscess may be nonspecific : including back pain, sepsis, with varying neurological deficits, which may present late. Magnetic resonance imaging (MRI) provides the most accurate definitive diagnosis. The treatment of choice in most patients is early neurosurgical decompression and antibiotic therapy. The most common causative organism in spinal epidural abscess is Staphylococcus aureus. Prompt diagnosis and specific therapy are the most important prognostic factors for a successful outcome. Conclusion : Iatrogenic spinal epidural abscess is a rare but serious complication which should be brought to the attention of all surgeons and anesthetists.
Persistent Identifierhttp://hdl.handle.net/10722/84535
ISSN
2015 Impact Factor: 0.394
2015 SCImago Journal Rankings: 0.286
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, YCen_HK
dc.contributor.authorDasey, Nen_HK
dc.date.accessioned2010-09-06T08:54:05Z-
dc.date.available2010-09-06T08:54:05Z-
dc.date.issued2007en_HK
dc.identifier.citationActa Chirurgica Belgica, 2007, v. 107 n. 2, p. 109-118en_HK
dc.identifier.issn0001-5458en_HK
dc.identifier.urihttp://hdl.handle.net/10722/84535-
dc.description.abstractBackground : Iatrogenic epidural abscess complicating neuro-axial blockade is rare, but carries significant morbidity and mortality if diagnosis is delayed. First documented in 1974, this disorder is now well described in the literature, and is increasing in incidence. Methods : A literature review was undertaken using Medline, all relevant papers on this rare, but important, complication of spinal epidural anesthesia or analgesia were used. Results : Widespread use of neuro-axial techniques in the peri-operative period such as epidural analgesia has probably contributed to improved surgical outcome but has also led to an increased incidence of complications. Epidural abscess or epidural catheter sepsis has previously been thought to occur rarely but recent publications suggest that it may be more frequent. Predisposing factors include old age, diabetes mellitus, alcoholism, cancer, and acquired immuno-deficiency syndrome. The signs and symptoms of epidural abscess may be nonspecific : including back pain, sepsis, with varying neurological deficits, which may present late. Magnetic resonance imaging (MRI) provides the most accurate definitive diagnosis. The treatment of choice in most patients is early neurosurgical decompression and antibiotic therapy. The most common causative organism in spinal epidural abscess is Staphylococcus aureus. Prompt diagnosis and specific therapy are the most important prognostic factors for a successful outcome. Conclusion : Iatrogenic spinal epidural abscess is a rare but serious complication which should be brought to the attention of all surgeons and anesthetists.en_HK
dc.languageengen_HK
dc.publisherAmerican Chemical Society. The Journal's web site is located at http://www.belsurg.org/journal.htmlen_HK
dc.relation.ispartofActa Chirurgica Belgicaen_HK
dc.subjectComplicationsen_HK
dc.subjectEpidural abscessaen_HK
dc.subjectMethicillin resistant Staphylococcus aureus (MRSA)en_HK
dc.subjectSpinal anesthesiaen_HK
dc.subject.meshAnalgesia, Epidural - adverse effectsen_HK
dc.subject.meshAnesthesia, Epidural - adverse effectsen_HK
dc.subject.meshAsepsisen_HK
dc.subject.meshBacteria - isolation & purificationen_HK
dc.subject.meshCatheterization, Peripheral - instrumentationen_HK
dc.subject.meshEpidural Abscess - diagnosis - etiology - therapyen_HK
dc.subject.meshEquipment Contamination - prevention & controlen_HK
dc.subject.meshHumansen_HK
dc.subject.meshIatrogenic Diseaseen_HK
dc.subject.meshPrognosisen_HK
dc.subject.meshRisk Factorsen_HK
dc.titleIatrogenic spinal epidural abscessen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1936-0851&volume=107&issue=2&spage=109&epage=118&date=2007&atitle=Iatrogenic+spinal+epidural+abscessen_HK
dc.identifier.emailChan, YC: ycchan88@hkucc.hku.hken_HK
dc.identifier.authorityChan, YC=rp00530en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid17515258-
dc.identifier.scopuseid_2-s2.0-34248377255en_HK
dc.identifier.hkuros145391en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34248377255&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume107en_HK
dc.identifier.issue2en_HK
dc.identifier.spage109en_HK
dc.identifier.epage118en_HK
dc.identifier.isiWOS:000246401600004-
dc.identifier.scopusauthoridChan, YC=27170769400en_HK
dc.identifier.scopusauthoridDasey, N=53874561700en_HK

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