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    982 embolisation of iatrogenic lumbar artery bleed causing psoas haematoma following elective lumbar puncture

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    Authors
    Oladeji, E.
    Rati, K.
    Rakhimova, K.
    Day, Nigel
    Affiliation
    Epsom and St Helier Hospitals, Sutton
    Issue Date
    2022
    
    Metadata
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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.
    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.
    Journal
    British Journal of Surgery
    URI
    http://hdl.handle.net/10541/625663
    DOI
    10.1093/bjs/znac269.170
    Additional Links
    https://dx.doi.org/10.1093/bjs/znac269.170
    Type
    Meetings and Proceedings
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1093/bjs/znac269.170
    Scopus Count
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    All Christie Publications

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