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KMID : 1155520190140010085
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Anesthesia and Pain Medicine
2019 Volume.14 No. 1 p.85 ~ p.90
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Paraplegia after celiac plexus neurolysis in a patient with pancreatic cancer - A case report and literature review -
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Kim Sung-Hoon
Jang Kyung-Hwan
Cheon Bo-Kyung
Lim Jeong-Ae
Woo Nam-Sik
Kim Hae-Kyung
Kim Jae-Hun
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Abstract
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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.
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KEYWORD
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Celiac plexus, Infarction, Pancreatic neoplasms, Paraplegia, Spinal cord
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