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Paraplegia following intraoperative celiac plexus injection.
1Department of Surgery, University of Florida College of Medicine, Gainesville, FL 32610-0286, USA.
Summary
Neurolytic celiac plexus injection offers pain relief for pancreatic cancer. Permanent paraplegia is a rare but serious complication, with this study detailing a third reported case following open injection with ethanol.
Area of Science:
- Pain Management
- Interventional Radiology
- Oncology
Background:
- Neurolytic celiac plexus injection, using ethanol or phenol, is a palliative technique for intractable pancreatic cancer pain.
- Prospective studies confirm its safety and efficacy, leading to widespread clinical adoption.
- Complications are generally minor and infrequent.
Observation:
- This report details a rare case of permanent paraplegia after open intraoperative neurolytic celiac plexus injection with 50% ethanol.
- This represents the third documented instance of permanent paraplegia following this specific procedure.
- Previous literature has documented 10 cases of transient or permanent paraplegia.
Findings:
- Permanent paraplegia is an exceptionally rare complication of neurolytic celiac plexus injection.
- Open intraoperative injection with 50% ethanol appears to be associated with this severe adverse event.
- The pathophysiology and risk factors require further investigation.
Implications:
- Highlights the critical need for meticulous technique and patient selection in neurolytic celiac plexus procedures.
- Underscores the importance of reporting rare but severe complications to refine safety protocols.
- Suggests a potential need for revised guidelines or enhanced monitoring for open intraoperative injections.