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KMID : 0359020130460030306
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Korean Journal of Gastrointestinal Endoscopy
2013 Volume.46 No. 3 p.306 ~ p.309
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Hepatic and Splenic Infarction and Bowel Ischemia Following Endoscopic Ultrasound-Guided Celiac Plexus Neurolysis
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Jang Hee-Yoon
Cha Sang-Woo
Lee Byung-Hoo
Jung Ho-Eun
Choo Jin-Woo
Cho Yun-Ju
Ju Hye-Young
Cho Young-Deok
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Abstract
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Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) is a well-established intervention to palliate malignant pain. We report a patient who developed hepatic and splenic infarction and bowel ischemia following EUS-CPN. A 69-year-old man with known lung cancer and pancreatic metastasis was transferred for debilitating, significant epigastric pain for several months. The patient underwent EUS-CPN to palliate the pain. After the procedure, the patient complained continuously of abdominal pain, nausea, and vomiting; hematemesis and hematochezia were newly developed. Abdominal computed tomography revealed infarction of the liver and spleen and ischemia of the stomach and proximal small bowel. On esophagogastroduodenoscopy, hemorrhagic gastroduodenitis, and multiple gastric ulcers were noted without active bleeding. The patient expired on postoperative day 27 despite the best supportive care.
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KEYWORD
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Celiac plexus neurolysis, Endoscopic ultrasound-guided fine needle aspiration, Infarction and ischemia
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