• Hinnerk Wulf, Anne-Friederike Lieb, Steffen Ruchholtz, and Claudius Thome.
• Robert-Bosch-Krankenhaus -Klinik Schillerhöhe in Gerlingen. thomas.frietsch@klinikschillerhoehe.de
• Anasthesiol Intensivmed Notfallmed Schmerzther. 2012 May 1;47(5):346-51.

AbstractThe rupture of a catheter near the spine is rare. There are no evidence-based guidelines for diagnosis and therapy. Opinions derived from German anesthesiologists, neurosurgeons, orthopaedics and trauma surgeons are: Infants should have immediate surgery. In an asymptomatic adult, the catheter fragment does not require removal surgery. Antibiotic prophylaxis is not necessary. If symptomatic, the catheter fragment should be localized by a thin slice computed tomography or fluoroscopy. Otherwise surgical exploration is indicated. Direct surgery is recommended for cases with neurological symptoms, infections, loss of spinal fluid, pain and local discomfort. Relative indications for surgery are severe pain, tissue infection and intrathecal localization of the fragment. Surgery should be performed in prone position and under general anesthesia. Starting at the entry wound, the surgical access should be microsurgical and preferably by a neurosurgeon. If the entry is not detectable, a midline incision is suggested.© Georg Thieme Verlag Stuttgart · New York.

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