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Seltene Komplikation der endoskopischen Nukleotomie

Rare complication after endoscopic discectomy

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Zusammenfassung

Operationen an der Lendenwirbelsäule zählen zu den orthopädischen und neurochirurgischen Standardeingriffen. Bei einer gesunden Patientin kam es nach endoskopischer Nukleotomie zu massiver Luftnot mit ausgeprägten Bauchschmerzen bei gespanntem Abdomen. Eine Sonographie offenbarte große Mengen freier Flüssigkeit in der Bauchhöhle, die sich nach Computertomographie (CT) und CT-gesteuerter Punktion als chirurgische Spüllösung herausstellte. Durch Anlage einer Drainage konnte eine Flüssigkeitsentlastung durchgeführt und die Patientin nach 24-stündiger Überwachung auf die periphere Station verlegt werden. Der Bericht stellt Komplikationen und anästhesiologische Besonderheiten im Rahmen perkutaner Wirbelsäuleneingriffe dar und nennt Differenzialdiagnosen der postoperativen Dyspnoe.

Abstract

Surgical treatment of the lumbar spine is a standard procedure in orthopedic and neurosurgery. After endoscopic discectomy an otherwise healthy patient developed massive dyspnea in combination with severe abdominal pain. Sonography revealed a large volume of free fluid in the abdominal cavity which proved to be surgical irrigation solution after computed tomography (CT) guided puncture. After insertion of a drainage channel fluid could be removed and the patient was transferred to a peripheral ward after a 24 h monitoring period. This review reports on the complications and anesthetic characteristics of percutaneous spinal interventions and presents differential diagnoses of postoperative dyspnea.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. T. Hilbert, O. Boehm, R. Pflugmacher, D.C. Wirtz, G. Baumgarten, P. Knuefermann geben an, dass kein Interessenkonflikt besteht. Der Beitrag enthält keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Deutschland

    T. Hilbert, O. Boehm, G. Baumgarten & P. Knuefermann

  2. Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Bonn, Bonn, Deutschland

    R. Pflugmacher & D.C. Wirtz

Authors
  1. T. Hilbert
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  2. O. Boehm
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  3. R. Pflugmacher
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  4. D.C. Wirtz
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  5. G. Baumgarten
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  6. P. Knuefermann
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Correspondence to T. Hilbert.

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Hilbert, T., Boehm, O., Pflugmacher, R. et al. Seltene Komplikation der endoskopischen Nukleotomie. Anaesthesist 63, 41–46 (2014). https://doi.org/10.1007/s00101-013-2279-2

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  • DOI: https://doi.org/10.1007/s00101-013-2279-2

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