[A Case of Epidural Hematoma after Removal of Epidural Catheter in a Patient with Coagulation Disorder].

A 75-year-old man with abdominal aortic aneurysm underwent Y-graft replacement under combination of general anesthesia and epidural anesthesia. Although we inserted an epidural catheter at first attempt from T11-12, nurse cut the epidural catheter accidently. We re-inserted from the same place. Postoperatively, we found hemopneumothorax in the chest Xp. The patient was transferred to ICU and mechanical ventilation was continued. The next day, he showed motor disturbance of both legs after waking up from sedation. The surgeon pulled out the epidural catheter. At that time, APTT was 41.5 sec, PT-INR was 1.32, PLT was 80,000. After one hour, he could move leg but had numbness of the left leg. MRI revealed epidural hematoma from T8 to T10. Although the cause of epidural hematoma remains unclear, we should have proposed to check anticoagulant data when catheter was pulled out from epidural space.