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KMID : 1040020160070010054
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International Journal of Pain
2016 Volume.7 No. 1 p.54 ~ p.58
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Psoas Hematoma with Lumbar Artery Pseudoaneurysm after Lumbar Sympathetic Plexus Block Accompanying Voiding Difficulty
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Lee Eun-Kyung
Sim Woo-Seog
Park Ji-Yeon
Lee Sang-Min M.
Lee Jin-Young
Choi Ji-Won
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Abstract
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Lumbar sympathetic plexus block has been performed under fluoroscopic guidance to prevent complications resulting from incorrect needle position. We report a case of acute psoas hematoma resulting from injury to the right 5th lumbar segmental artery following a procedure using a mixture of 4 ml 0.5% levobupivacaine and 4 ml 4% lidocaine at the 4th lumbar spine level on the right side. About 1 hour after the procedure, the patient complained of severe right inguinal and flank pain. Symptoms and physical exam suggested involvement of the psoas muscle. A psoas hematoma with pseudoaneurysm in the right paravertebral area was found on abdominopelvic computed tomography scan. Coil embolization of the 5th lumbar artery was performed. However, the patient complained of voiding difficulty. Lumbar sympathetic plexus block is a generally safe and effective method for sympathetically mediated pain; however, this case highlights the potential risk of lumbar artery injury.
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KEYWORD
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lumbar sympathetic plexus block, psoas hematoma, vessel injury, voiding difficulty
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