Abscess Epidural

Epidural abscess is an inflammation of the epidural space located between the outer dura mater and the bone of the spine, characterized by the accumulation of purulent exudate. Subsequently, a cavity is formed filled with pus and waste products of microbes.

Older people are at risk

An abscess of the epidural space is a focus of purulent inflammation of the epidural tissue, which can develop both on the dura mater and in a retroperitoneal location and spread both in the pelvic cavity and into the intercellular spaces of the posterior surface of the lumbar vertebrae and sacrum. In surgery of the hypogastric space, it is customary to talk about an epidural abscess.

The most common cause of the formation of this purulent-inflammatory focus is an infection of the skin and subcutaneous tissue, traumatized by the insertion of a needle into the area of ​​innervation or surgical intervention in the hypogastric region. Other possible causes of epidural abscesses, such as actinomycosis (as an exception), purulent peritonitis, hemophilus influenzae infection. It is due to the mechanisms of damage to the epidermal barrier that the initial penetration of infection into the epidural space is created. Development is facilitated by injuries, careless manipulations after operations, animal bites, pregnancy and childbirth, in some cases they occur against the background of primary acute or chronic pancreatitis. When inflammation is localized between the dura mater and the dermis (skin tissue), with the exception of the acute phase, a chronic persistent limitation of back mobility in children develops, chronic compression of the spinal roots during the formation of a fistula or its breakthrough in the tissue. Symptoms of acute inflammation may occur. With total damage, epidurals cause compression on the perioral intestine, which impedes the flow of venous blood from the perinephric rectum. As a result, after a few days, abdominal syndrome develops (irradiation of pain, characteristic irradiating pain, dysuric phenomena with anuria, diffuse pain in the hypogastrium and increased temperature). With a breakthrough into the subperitoneal tissue, a pathology of the lumbar region is formed. If the involvement of the fiber extends caudally, this causes the development of pyostatic deformation of the pelvic bones, due to which the osteocartilaginous walls of the acetabulum and the lower edge of the wing of the talus are displaced. The pelvic ring abscess cavity displaces the femoral head or neck of the femur. Sometimes, in parallel with the main pathology, acute purulent myonecrosis occurs in 2-3 cases due to damage to the fibers of the inguinal muscle (the posture of a person “leaning” backwards or hanging from the bed). This subsequently leads to muscle atrophy and failure due to reduced blood flow. During infectious spread