Background: Regional anesthetic techniques on the neuroaxis are common procedures in Anesthesia. They are not exempt from complications. Spinal epidural haematoma (SEH) is the most uncommon and severe. To reduce its incidence we must consider different factors such as coagulation lab tests, anticoagulation and antiplatelet drugs or the moment for removing the epidural catheter.
Case Report:  We present a case of a 41 years old women, ASA II, with a diagnose of a metastatic neuroendocrine intestinal tumor who is programmed for surgery. Presurgery blood tests are normal. Before surgery, an epidural catheter is atraumatically placed between D10-D11 space without any incidence. Surgery is uneventful. Removal of the catheter is done respecting the safe intervals of the thromboprophylaxis therapy. 24 hours after catheter removal, the patient presents paresthesias and hipoesthesia from D10 level. A magnetic resonance imaging (MRI) is performed and an haematoma compressing the spinal cord expanded from D8 to D10 is observed. An urgent drainage and laminoplasty is carried out within the first 12h since the beginning of the symptoms. She gradually recovered from neurological symptoms.
Discussion: We report this case to analyze which factors take action in the onset of SEH, its diagnose and therapeutic management. Despite performing the epidural puncture and removal of the catheter according to the clinical guidelines a SEH appeared. We analyze two aspects which might be a  cause of SEH: the diagnose of a carcinoid syndrome related to the tumor and the suspicion of an intradural migration of the epidural catheter


05 / Case report: spinal epidural haematoma as a complication of removing a thoracic epidural catheter.