A case of a patient with a Bartholin gland cyst and a severe complication after spinal anesthesia

Artur Skowyra, R Michalik, Monika Panek, M Panek, Monika Bączkowska, Michał Ciebiera
In: Journal of Endometriosis and Pelvic Pain Disorders · 2025 · vol. 17(4) , pp. 226–229 · doi:10.1177/22840265251342101 · W4411131411
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This case report describes a patient who developed spinal cord hematomas and subsequent neurological deficits after undergoing elective surgery for a Bartholin gland cyst under spinal anesthesia.

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This case report describes a patient who developed a severe complication following spinal anesthesia for the surgical management of a Bartholin gland cyst. The authors detail the clinical presentation and course of this adverse event, highlighting the risks associated with regional anesthesia in gynecological procedures. While published in the Journal of Endometriosis and Pelvic Pain Disorders, the article focuses exclusively on an infectious or anatomical issue of the vulva rather than pelvic pain syndromes. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Bartholin glands are paired, mucus-secreting glands, located on both sides of the vaginal opening. Bartholin gland cysts or abscesses mostly occur during the reproductive period and primarily manifest with local pain. The symptomatic ones require treatment, usually on an outpatient basis, with the use of anesthesia. A 59-year-old woman was admitted for elective surgery for a symptomatic, constantly growing Bartholin gland cyst. On admission, the cyst was about 4–5 cm in diameter. The procedure was performed under subarachnoid block. The anesthesia, surgery, and postoperative period were uneventful. On the second day after the procedure, the patient presented to the hospital due to vomiting, malaise, and blood pressure being elevated to 170/100 mm Hg. The post-puncture syndrome was ruled out. Laboratory tests showed no signs of inflammation. On the next day, the patient reported the paresthesia of the lower extremities and gait disturbance. The MRI of the spine showed supratentorial hematomas of the spinal cord at Th6–S1. Decompressive laminectomy was performed at L1–L2 leaving a drain in the surgical lamina. During the postoperative course, the symptoms subsided, limb functions and muscle strength improved, and the patient was discharged home without assistance. The presented case demonstrates that every surgical procedure performed in a patient may cause serious complications. Therefore, the qualification for surgical procedure should be performed carefully and patients should be well informed about the possible complications. It is crucial to provide patients with an optimally early follow-up to detect early and dangerous complications.
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