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REGIONAL ANESTHESIA

Postdural Puncture Headache with Abdominal Pain and Diarrhea

Chih-Ping Yang, MD^*, Chian-Her Lee, MD, Cecil O. Borel, MD, Chun-Chang Yeh, MD, Chueng-He Lu, MD, Chih-Shung Wong, MD, PhD, and Ching-Tang Wu, MD

*Division of Anesthesiology, Armed Forces Taoyuan General Hospital; Departments of Anesthesiology and Orthopaedic Surgery, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China; and Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina

Address correspondence and reprint requests to Ching-Tang Wu, MD, Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, #325, Section 2, Chenggung Rd., Neihu 114, Taipei, Taiwan, Republic of China. Address e-mail to wuchingtang{at}msn.com.

Dural puncture or a rent in the dura with prolonged cerebrospinal fluid leakage may cause noninfectious arachnoiditis and may be associated with urinary and fecal incontinence. Visceral dysfunction is common for patients with noninfectious arachnoiditis of the lumbosacral nerve roots after dural puncture. We report a case of postdural puncture headache associated with abdominal pain and diarrhea. An epidural blood patch was performed, and all symptoms resolved after 5 days. After exclusion of organic and psychological disorders, this treatment might be considered for patients who are experiencing abdominal pain and diarrhea after dural puncture.