982 embolisation of iatrogenic lumbar artery bleed causing psoas haematoma following elective lumbar puncture
Oladeji, E. Rati, K. Rakhimova, K. Day, Nigel
Oladeji, E.
Rati, K.
Rakhimova, K.
Day, Nigel
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Abstract
The case of a 59-year-old female patient presenting as a surgical
emergency with abdominal pain and a positive Obraztsova’s sign.
Seven days prior to the presentation, she had attended her General
Practice (GP) complaining of sudden onset severe occipital headache
associated with photophobia, vertigo, and paraesthesia. Due to a
family history of cerebral aneurysms, her GP urgently transferred her
to an emergency department, where she was subsequently admitted
under the acute medical team. A lumbar puncture (LP) had been
performed to exclude a subarachnoid haemorrhage. The patient was
investigated with a Computerised Tomography abdomen and pelvis
with contrast and was subsequently found to have an acute lumbar
arterial bleed causing haemodynamic instability and a psoas
haematoma. An emergency lumbar artery embolisation procedure
was performed by the interventional radiology department in order to
stabilise the bleed. The patient made a full recovery prior to discharge.
This rare case exemplifies the value of obtaining adequate history in
arriving at a diagnosis. In the appropriate clinical context, a
contrast-enhanced CT scan of the abdomen and pelvis should be
obtained to exclude this treatable condition. Also, measures to
minimize the risk of complications and make lumbar puncture safer
should be incorporated into guidelines, including methods to ensure
that the correct position of L3/L4 or L4/L5 is found prior to performing
the procedure, use of atraumatic spinal needles and performing the
procedure under ultrasound guidance.
Authors
Affiliation
Description
Date
2022
Publisher
Collections
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Meetings and Proceedings
Citation
Oladeji E, Rati K, Rakhimova K, Day N. 982 Embolisation of Iatrogenic Lumbar Artery Bleed Causing Psoas Haematoma Following Elective Lumbar Puncture. British Journal of Surgery. 2022 Aug;109(SUPPL 6). PubMed PMID: WOS:000842588600012.