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Celiac Plexus Block Complications: A Case Report and Review of the Literature

机译:乳糜泻神经丛阻滞并发症的病例报告和文献综述

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摘要

Celiac plexus block (CPB) has been widely used as a treatment option for chronic intractable abdominal pain resulting from intra-abdominal malignancies as well as benign conditions. Complications resulting from CPB have been long reported and include diarrhea, back pain, paraplegia, postural hypotension, pneumothorax, and local anesthesia toxicity. Diarrhea and postural hypotension are two most common complications with studies reporting incidences occurring in 44% to 60% and 10% to 52% of patients, respectively. Diarrhea is most often transient, resolving within 48 hours; however, literature reports cases in which diarrhea was chronic, debilitating, and in some instances life threatening. Persistent diarrhea proves difficult to treat. We report a case of a 76-year-old male with unresectable pancreatic adenocarcinoma who underwent computed tomography-guided CBP complicated by persistent diarrhea and fecal incontinence. After conventional antidiarrheal failed to improve the symptoms, octreotide proved to be beneficial and the patient reported significant improvement in symptoms.
机译:乳糜泻神经丛阻滞 (CPB) 已被广泛用作腹腔内恶性肿瘤和良性疾病引起的慢性顽固性腹痛的治疗选择。CPB 引起的并发症早有报道,包括腹泻、背痛、截瘫、体位性低血压、气胸和局部麻醉中毒。腹泻和体位性低血压是两种最常见的并发症,研究报告分别发生率为 44%-60% 和 10%-52% 的患者。腹泻通常是短暂的,在 48 小时内消退;然而,文献报道了腹泻是慢性的、使人衰弱的,在某些情况下危及生命的病例。持续性腹泻难以治疗。我们报告了一例 76 岁男性不可切除的胰腺癌病例,他接受了计算机断层扫描引导下的 CBP,并发持续性腹泻和大便失禁。在常规止泻药未能改善症状后,奥曲肽被证明是有益的,患者报告症状有显着改善。

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