Renal Subcapsular Hematoma after Lumbar Plexus Block

THE lumbar plexus, which branches to the genitofemoral, lateral femoral cutaneous, obturator, femoral, and lumbosacral nerves, is located between the quadratus lumborum and psoas major muscles (a part of the plexus is contained within the psoas major muscle). Lumbar plexus block (LPB) has been described for use in patients with lumbosacral and lower extremity pain. 1-4 Psoas compartment block is one form of LPB. 1 Because the lumbar plexus is adjacent to the retroperitoneum and peritoneal cavity, introduction of a block needle into adjacent structures, such as the kidney, may result in complications. In the method described by Chayen et al., 1 an approach for LPB at the level of L4 vertebral body was presented. However, some practitioners introduce the block needle at the L3 level, 4 at which there is a probability that the needle tip will be introduced into the kidney (fig. 1). We present two cases of renal subcapsular hematoma subsequent to LPB at the L3 level.