• Xueliang Cheng, Yang Qu, Rongpeng Dong, Lili Yang, Mingyang Kang, and Jianwu Zhao.
• The 2nd Hospital of Jilin University, Changchun, Jilin, People's Republic of China.
• Medicine (Baltimore). 2020 Aug 14; 99 (33): e21762.

IntroductionThere have been few case reports of abdominal pain as a symptom of spontaneous intraspinal hemorrhage. We herein describe a case involving a girl with paraplegia caused by spontaneous epidural hemorrhage in the thoracic spinal canal, characterized by abdominal pain.Patient ConcernsAn 8-year-old girl with sudden abdominal pain and back pain was misdiagnosed as having an abdominal disease until she had the symptom of paralysis.DiagnosesThe patient was diagnosed with spontaneous intraspinal hemorrhage masquerading as atypical abdominal pain.InterventionsWhen the patient developed symptoms of lower extremity paralysis, thoracic magnetic resonance imaging was performed and epidural hemorrhage was found in the thoracic spinal canal. Surgical treatment was performed after the diagnosis was confirmed.OutcomesThe patient could almost walk normally after 3 months. One year after surgery, the Frankel grade of spinal cord function was grade D. We continued to follow-up this patient.ConclusionThe symptoms caused by intraspinal hemorrhage are mainly back pain with or without neurological dysfunction. However, sometimes atypical symptoms, such as abdominal and chest pain, can be identified in clinical settings. Emergency surgery is recommended as the treatment of choice for intraspinal hemorrhage with neurological dysfunction.

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