Epidural Hematoma in Minor Hepatic Metastasectomy

TL;DR

This case report highlights a rare epidural hematoma after liver surgery, emphasizing the need for better coagulation assessment beyond traditional methods.

Contribution

The paper introduces the potential use of viscoelastic testing to improve coagulation assessment in patients undergoing liver surgery.

Findings

An epidural hematoma occurred after epidural catheter removal following minor liver surgery.

Traditional coagulation parameters may not fully capture coagulation risks after partial hepatectomy.

Viscoelastic testing could provide more accurate hemostatic assessment in these patients.

Abstract

Liver resection poses many challenges for the anesthesiologist, including intraoperative hemodynamic instability, postoperative pain, and risk of coagulopathy. We report a case of epidural hematoma after epidural catheter removal, following a minor liver single metastasectomy. The main purpose of this case report is to bring to light the false security provided by traditional coagulation parameters and whether further investigation should be considered in selected cases, before handling neuraxial catheters. Alterations in coagulation after a partial hepatectomy remain poorly understood; thus, we believe that additional hemostatic values such as viscoelastic testing might be considered to better assess these patients.

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