Epidural Hematoma as a Cause of Postpneumonectomy Paraplegia

Perez-Guerra, Francisco; Holland, Joseph M.

doi:10.1016/s0003-4975(10)62599-4

Cited by 12 publications

(7 citation statements)

References 2 publications

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“…Manoeuvers aimed at haemostasis at the posterior edge of a posterolateral thoracotomy such as packing the wound with haemostatic agents or electrocauterisation could create a pleural epidural or even a pleural subarachnoidal communication through the intervertebral foramen. 4,9 In the presence of an intact pleura, the epidural space has no communication with the pleural cavitiy. The distance that separates the pleural cavitiy posteriorly from the spinal canal and the dura through the intervertebral foramina is very short and the intervertebral foramine do not form a strong barrier protecting the spinal cord.…”

Section: Discussionmentioning

confidence: 99%

Oxidised regenerated cellulose as a cause of paraplegia after thoracotomy: case report and review of the literature

2005

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Study design: Case report. Objective: To report an unusual case of paraplegia. Setting: University Hospital Bursa, Turkey. Case report: A 22-year-old woman presented with paraplegia following a left-sided thoracotomy. Magnetic resonance imaging showed a dorsal epidural mass at the level of T6. The patient underwent an emergency T6/7 laminectomy and removal of a tuft of oxidised regenerated cellulose, which had migrated through the intervertebral foramen causing spinal cord compression. Conclusion: In cases of neurological deficits after surgery at the posterolateral edge of a thoracotomy, the clinician should be aware of the above possibility. Urgent radiological diagnosis and decompressive laminectomy is the treatment of choice.Spinal Cord (2005) 43, 445-447.

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Section: Discussionmentioning

confidence: 99%

Oxidised regenerated cellulose as a cause of paraplegia after thoracotomy: case report and review of the literature

2005

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“…1,5,s,s,~~ The most common cause is spinal cord ischemia due to a compromised blood supply. 2'3"5'6'9-11 In a few cases an epidural hematoma has been reported as a cause of paraplegia.~' 8 We describe two uncommon cases in which no neurological complication existed immediately after lobectomy but paraplegia developed some hours later secondary to expanded hemostatic agents migrating into the epidural space.…”

mentioning

confidence: 96%

Epidural migration of hemostatic agents as a cause of postthoracotomy paraplegia

Wada¹,

Yonenobu²,

Ebara³

et al. 1993

Journal of Neurosurgery

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“…Among all 38 cases described, plus our reported case, 11 patients were treated conservatively due to suspicion of an OC-retaining lesion after surgical history evaluation and multidisciplinary analysis by surgeons and radiologists. Although retained OC has been described by many authors [ 27 – 29 , 31 , 32 , 34 – 56 ], we believe it is important to focus on the cases in which there were severe complications in order to form some conclusions and recommendations…”

Section: Discussionmentioning

confidence: 99%

Practical Suggestions for Prevention of Complications Arising from Oxidized Cellulose Retention: A Case Report and Review of the Literature

et al. 2018

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Patient: Male, 51Final Diagnosis: Oxidised cellulose retainSymptoms: Abdominal pain • nausea • vomitingMedication: —Clinical Procedure: Laparoscopic abdominal exploration and drainageSpecialty: SurgeryObjective:Challenging differential diagnosisBackground:Bleeding is a major intraoperative complication during surgical procedures. When conventional methods such as ligature and diathermocoagulation are ineffective for bleeding management, hemostatic agents should be used. Oxidized cellulose is one of the major hemostatic agents used worldwide. Oxidized cellulose is often left in situ after hemostasis because of its high level of reabsorption that lasts up to 8 weeks. However, 38 cases of retaining-associated complications are reported in the literature.Case Report:A 51-year-old male patient presented in our emergency department with acute abdominal pain, nausea, and vomiting. The patient had been admitted in our department for laparoscopic cholecystectomy for acute cholecystitis 25 months previously. Abdominal ultrasound and CT scan showed the presence of a cystic circular mass, with homogeneous fluid content, close to the surgical clips of the previous surgery, resembling a “neo-gallbladder”. Laparoscopic abdominal exploration and drainage were performed. Histological examination reported protein-based amorphous material with rare lymphocytes and macrophages. Culturing was negative for bacterial growth. The patient was discharged uneventfully on the 4th postoperative day. The primary surgical report was evaluated with evidence of application of Gelita-Cel® Standard for hemostatic purposes. Results of 12-month follow-up were normal.Conclusions:Herein, we report the first case of a complication associated with the use of Gelita-Cel® Standard. We reviewed the literature to better define the purpose and limits of oxidized cellulose use as a hemostatic agent. Despite the fundamental role of oxidized cellulose as a hemostatic agent, we provide some practical suggestions to prevent the reported severe complications and surgical overtreatments.

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Epidural Hematoma as a Cause of Postpneumonectomy Paraplegia

Cited by 12 publications

References 2 publications

Oxidised regenerated cellulose as a cause of paraplegia after thoracotomy: case report and review of the literature

Oxidised regenerated cellulose as a cause of paraplegia after thoracotomy: case report and review of the literature

Epidural migration of hemostatic agents as a cause of postthoracotomy paraplegia

Practical Suggestions for Prevention of Complications Arising from Oxidized Cellulose Retention: A Case Report and Review of the Literature

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