RESUMEN
Resumen: La anestesia epidural es una técnica que se realiza a ciegas y que por ende no está exenta de complicaciones; entre ellas, una poco común es la formación de un nudo verdadero. Se discute el caso de una gestante, a la cual se colocó bloqueo epidural con formación de un nudo verdadero que fue extraído quirúrgicamente. Conclusión: Si un catéter epidural no puede ser retirado de manera fácil, se deben aplicar maniobras descritas para el retiro del mismo y se puede ayudar de estudios de imagen como TAC o IRM para saber la forma y posición del catéter y, si el catéter tiene comunicación con el exterior, se debe extraer quirúrgicamente.
Abstract: Epidural anesthesia is a technique that is performed blindly and therefore is not free of complications, among them, a rare complication is the formation of a true knot. We discuss the case of a pregnant woman in whom an epidural block with a true knot formation was placed, which was surgically removed. Conclusion: If an epidural catheter cannot be removed easily, maneuvers described for removal should be applied and imaging studies such as CT or MRI may be used to determine the shape and position of the catheter and whether the catheter has communication with the outside must be extracted surgically.
RESUMEN
Abstracts: Background: Nasogastric aspiration is bedside procedure in surgical wards. Amount and type of nasogastic drainage is helpful in establishing conditions such as intestinal obstruction and its level. Knotted nasogastric tube is rarely reported in literature. In our case of intestinal obstruction this rare condition led to a diagnostic dilemma. Through this we want to highlight that in patients with intestinal obstruction and inadequate nasogastric tube drainage, possibility of this rare complication should be thought of.
RESUMEN
The occurrence of knots and loops is a potential hazard of a balloon-tipped, flow-directed pulmonary artery (PA) catheter placement if excessive catheter length is passed into the right atrium or ventricle. Knotting of a balloon-tipped, flow-directed PA catheter leading to difficulty in its removal is a rare but serious complication. A case of knotted catheter in right atrium in a patient undergoing aortic valve replacement is presented. By passing a spring guidewire into PA catheter, we have untied the loose knotted catheter under simple fluoroscopic guidance in the intensive care unit.