Coeliac plexus block in the management of chronic abdominal pain due to severe diabetic gastroparesis
Abdominal pain can be disabling in patients with gastroparesis. The pathogenesis of pain in these individuals is poorly understood. Agents commonly used in clinical practice, including tricyclic antidepressants, gabapentin, and pregabalin, have remained largely unsatisfactory in treating this pain....
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| Veröffentlicht in: | BMJ case reports 2009, Vol.2009 (nov26 1), p.bcr0620091986-bcr0620091986 |
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| container_issue | nov26 1 |
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| container_title | BMJ case reports |
| container_volume | 2009 |
| creator | Wu, Dennis Jason Yang Dib, Chadi Hoelzer, Bryan McMahon, Molly Mueller, Paul |
| description | Abdominal pain can be disabling in patients with gastroparesis. The pathogenesis of pain in these individuals is poorly understood. Agents commonly used in clinical practice, including tricyclic antidepressants, gabapentin, and pregabalin, have remained largely unsatisfactory in treating this pain. We report the case of a 50-year-old woman presenting with chronic unrelenting abdominal pain due to severe diabetic gastroparesis that was managed successfully with coeliac plexus block with local anaesthesia and steroid injection. Adequate analgesia was achieved and maintained for 10 weeks following the coeliac plexus block, which allowed elimination of opiate requirements for pain management (and avoidance of narcotic associated constipation), continuation of percutaneous endoscopy jejunostomy tube feedings, and avoidance of long term parenteral nutrition. |
| doi_str_mv | 10.1136/bcr.06.2009.1986 |
| format | Article |
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The pathogenesis of pain in these individuals is poorly understood. Agents commonly used in clinical practice, including tricyclic antidepressants, gabapentin, and pregabalin, have remained largely unsatisfactory in treating this pain. We report the case of a 50-year-old woman presenting with chronic unrelenting abdominal pain due to severe diabetic gastroparesis that was managed successfully with coeliac plexus block with local anaesthesia and steroid injection. Adequate analgesia was achieved and maintained for 10 weeks following the coeliac plexus block, which allowed elimination of opiate requirements for pain management (and avoidance of narcotic associated constipation), continuation of percutaneous endoscopy jejunostomy tube feedings, and avoidance of long term parenteral nutrition.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr.06.2009.1986</identifier><identifier>PMID: 22121392</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Abdomen ; Female ; Novel Treatment (New Drug/Intervention; Established Drug/Procedure in New Situation) ; Nutrition ; Pain management ; Parenteral nutrition ; USA/Canada ; White</subject><ispartof>BMJ case reports, 2009, Vol.2009 (nov26 1), p.bcr0620091986-bcr0620091986</ispartof><rights>2009 BMJ Publishing Group Ltd</rights><rights>Copyright: 2009 2009 BMJ Publishing Group Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b3746-7e46efcf9378f5c3059d7e848bbc1b111a1576c6f5a47231e7195ea0a41b2a083</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3027778/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3027778/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,4024,27923,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22121392$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wu, Dennis Jason Yang</creatorcontrib><creatorcontrib>Dib, Chadi</creatorcontrib><creatorcontrib>Hoelzer, Bryan</creatorcontrib><creatorcontrib>McMahon, Molly</creatorcontrib><creatorcontrib>Mueller, Paul</creatorcontrib><title>Coeliac plexus block in the management of chronic abdominal pain due to severe diabetic gastroparesis</title><title>BMJ case reports</title><addtitle>BMJ Case Rep</addtitle><description>Abdominal pain can be disabling in patients with gastroparesis. 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| subjects | Abdomen Female Novel Treatment (New Drug/Intervention Established Drug/Procedure in New Situation) Nutrition Pain management Parenteral nutrition USA/Canada White |
| title | Coeliac plexus block in the management of chronic abdominal pain due to severe diabetic gastroparesis |
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