Management of Retained Epidural Catheter Fragment in a Polytrauma Patient: A Case Report
Year: 2026
Type: article
Abstract: Introduction: Epidural catheterization is a commonly performed procedure for perioperative analgesia in orthopedic surgery. Catheter fracture is an uncommon but potentially challenging complication that may present a management dilemma when a retained fragment is identified. Although retained fragments have traditionally been considered biologically inert, delayed complications, such as radicular pain, migration, and fibrosis have been reported. However, consensus regarding optimal management remains lacking. Case Report: We report a case of an epidural catheter fracture during insertion, with a retained fragment confirmed by comparison with the original catheter. Localization was done using computed tomography at the L3-L4 level, extending from the interspinous region towards the posterior epidural space. The patient remained neurologically intact throughout the course of treatment. During a subsequent planned orthopedic procedure, retrieval of the retained catheter fragment was performed through a limited posterior approach. The fragment was successfully removed under direct visualization without dural breach or cerebrospinal fluid leak. The post-operative course was uneventful, and the patient remained asymptomatic at follow-up. Discussion: Management of retained epidural catheter fragments remains debated. While conservative observation has been reported in asymptomatic patients, delayed complications, including migration, fibrosis, and neurological symptoms have also been described. Careful radiological localization and correlation with clinical features are important when formulating a management strategy. This case highlights the role of individualized decision-making and multidisciplinary planning in the management of retained epidural catheter fragments.
Institution: All India Institute of Medical Sciences
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $250
OpenAlex ID: W7225584855
FWCI:
Cites:
Cited by:
Related to: