フクハラ　トオル   Toru Fukuhara   福原　徹    所属   川崎医科大学  医学部 臨床医学　脳神経外科学２    職種   特任教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Tangled catheter as a rare cause of baclofen pump malfunction.
掲載誌名	正式名：Surg Neurol.
掲載区分	国外
巻・号・頁	72(1),pp.80-82
著者・共著者	FukuharaToru,TanakaT,NambaY,KuyamaH
担当区分	筆頭著者
発行年月	2009/07
概要	BACKGROUND: Several catheter problems have been reported as causes of baclofen pump malfunction; however, a tangled catheter has never been described. CASE DESCRIPTION: A 52-year-old woman with bilateral leg spasticity because of spinal multiple sclerosis underwent baclofen pump implantation, which was subcutaneously placed in the right upper quadrant. She visited for a pump refill 3 months postimplantation with reworsening of her leg spasticity. It was noted that there was more baclofen remaining in the pump than programmed. Abdominal x-ray indicated the kink of the catheter around the pump, and the catheter was explored under local anesthesia. Upon exposure, the catheter was found to be tangled. After the revision of this tangled catheter, the patient's spasticity improved again. CONCLUSIONS: Although the exact mechanism of this complication is unknown, the friction-compression of the catheter against the iliac bone may be the cause. Implanting the pump away from the bony formation may avoid catheter entanglement