Paraplegia after celiac plexus neurolysis in a patient with pancreatic cancer: A case report and literature review.
10.17085/apm.2019.14.1.85
- Author:
Sung Hoon KIM
1
;
Kyung Hwan JANG
;
Bo Kyung CHEON
;
Jeong Ae LIM
;
Nam Sik WOO
;
Hae Kyung KIM
;
Jae hun KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea. painfree@kuh.ac.kr
- Publication Type:Case Report
- Keywords:
Celiac plexus;
Infarction;
Pancreatic neoplasms;
Paraplegia;
Spinal cord
- MeSH:
Aged;
Celiac Plexus*;
Contrast Media;
Gray Matter;
Humans;
Hypesthesia;
Infarction;
Lower Extremity;
Magnetic Resonance Imaging;
Male;
Pancreatic Neoplasms*;
Paralysis;
Paraplegia*;
Perfusion;
Prone Position;
Spinal Cord;
Spine
- From:Anesthesia and Pain Medicine
2019;14(1):85-90
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 65-year-old male patient underwent C-arm fluoroscopy-guided bilateral celiac plexus neurolysis to relieve peritoneal seeding-related pain associated with pancreatic cancer. Following confirmation of spreading, and no intravascular injection of contrast media, 7.5 ml of 0.25% chirocaine was injected in each side. The pain subsided after the block, with no motor or sensory deficits. Subsequently, celiac plexus neurolysis with 99.8% alcohol was performed using a posterolateral approach under fluoroscopic guidance. The patient was instructed to maintain a prone position for 2 hours while the procedure was performed. Approximately 4 hours later, the patient experienced paralysis of both lower extremities and hypoesthesia. Emergent magnetic resonance imaging of the thoracic and lumbar spine revealed gray matter signal change in the cord and conus medullaris at the T10-L1 level, and decreased perfusion at the T11-T12 vertebral bodies, suggesting spinal cord infarction. The patient remained paraplegic until his death 24 days later.
