Epidural and Psoas Abscesses Recognized after Paravertebral Trigger Point Injection -A case report-

척추 주위근 통증유발점주사 후 발생한 경막외와 요근 농양 -증례보고-

  • Kim, Dong Hee (Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University) ;
  • Kim, Hee Soo (Department of Anesthesiology and Pain Medicine, College of Medicine, Dankook University)
  • 김동희 (단국대학교 의과대학 마취통증의학교실) ;
  • 김희수 (단국대학교 의과대학 마취통증의학교실)
  • Received : 2007.01.08
  • Accepted : 2007.05.10
  • Published : 2007.06.30

Abstract

The trigger point injection technique is widely used in pain clinics for the treatment of acute and chronic pain. Yet it has a variety of complications such asvasovagal syncope, total spinal anesthesia, paralysis, root block, pneumothorax, needle breakage, skin infection, and hematoma formation. Among them, the simultaneous occurrence of psoas and epidural abscesses is extremely rare. We report here on a patient who was diagnosed with epidural and psoas abscesses after paravertebral trigger point injection.

Keywords

References

  1. Hopwood MB, Abram SE: Factors associated with failure of trigger point injections. Clin J Pain 1994; 10: 227-34 https://doi.org/10.1097/00002508-199409000-00009
  2. Elias M: Cervical epidural abscess following trigger point injection. J Pain Symptom Manage 1994; 9: 71-2 https://doi.org/10.1016/0885-3924(94)90156-2
  3. Knight JW, Cordingley Jl, Palazzo MG: Epidural abscess following epidural steroid and local anaesthetic injection. Anaesthesia 1997; 52: 576-8 https://doi.org/10.1111/j.1365-2044.1997.156-az0161.x
  4. Goldberg B, Hedges JR, Stewart DW: Psoas abscess. J Emerg Med 1984; 1: 533-7 https://doi.org/10.1016/0736-4679(84)90007-6
  5. Desandre AR, Cottone FJ, Evers ML: Iliopsoas abscess: etiology, diagnosis, and treatment. Am Surg 1995; 61: 1087-91
  6. Kim DH, Kim DC, Lee JR, Han YJ, Choe H: Epidural abscess after epidural block for pain management. Korean J Pain 2003; 16: 286-90
  7. Fischer AA: New approaches in treatment of myofascial pain. Phys Med Rehabil Clin North Am 1997; 8: 153-69
  8. Ruoff GE: Technique of trigger point injection. In: Procedures for primary care physicians. Edited by Pfenninger JL, Fowler GC: St. Louis, Mosby. 1994, pp 164-7
  9. Finnerty RU, Vordermark JS 2nd, Modarelli RO, Buck AS: Primary psoas abscess: case report and review of literature. J Urol 1981; 126: 108-9 https://doi.org/10.1016/S0022-5347(17)54402-X
  10. Santaella RO, Fishman EK, Lipsett PA: Primary vs secondary iliopsoas abscess. Presentation, microbiology, and treatment. Arch Surg 1995; 130: 1309-13 https://doi.org/10.1001/archsurg.1995.01430120063009
  11. Chern CH, Hu SC, Kao WF, Tsai J, Yen D, Lee CH: Psoas abscess: making an early diagnosis in the ED. Am J Emerg Med 1997; 15: 83-8 https://doi.org/10.1016/S0735-6757(97)90057-7
  12. Rigamonti D, Liem L, Sampath P, Knoller N, Namaguchi Y, Schreibman DL, et al: Spinal epidural abscess: contemporary trends in etiology, evaluation, and management. Surg Neurol 1999; 52: 189-96 https://doi.org/10.1016/S0090-3019(99)00055-5
  13. Bluman EM, Palumbo MA, Lucas PR: Spinal epidural abscess in adults. J Am Acad Orthop Surg 2004; 12: 155-63 https://doi.org/10.5435/00124635-200405000-00003
  14. Lipsky BA, Pecoraro RE, Chan MS, Koepsell TD: Factors affecting staphylococcal colonization among NIDDM outpatients. Diabetes Care 1987; 10: 483-6 https://doi.org/10.2337/diacare.10.4.483
  15. Saunders S: Injection techniques in orthopaedic and sports medicine. 2nd ed. Edinburgh, W.E. Saunders. 2002, p 13