Long-Lasting Orthostatic Hypotension and Constipation After Celiac Plexus Block; A Case Report

Area of Science:

• Gastroenterology
• Pain Management
• Neurology

Background:

• Metastatic pancreatic cancer often presents with significant abdominal pain, necessitating effective pain management strategies.
• Celiac plexus block is a recognized intervention for alleviating abdominal pain associated with pancreatic cancer.
• Autonomic nervous system function can be impacted by interventions targeting the celiac plexus.

Observation:

• A 55-year-old male patient with metastatic pancreatic cancer experienced abdominal pain.
• The patient underwent a celiac plexus block for pain management.
• Following the procedure, the patient developed persistent symptoms of orthostatic hypotension and constipation.

Findings:

• The celiac plexus block, intended for pain relief, resulted in long-lasting autonomic dysfunction.
• Orthostatic hypotension, characterized by a drop in blood pressure upon standing, was a significant adverse effect.
• Chronic constipation was another persistent complication observed post-procedure.

Implications:

• This case underscores the potential for significant, long-term autonomic side effects from celiac plexus blocks.
• Clinicians should be vigilant for and prepared to manage autonomic complications such as orthostatic hypotension and constipation after celiac plexus block.
• Further research may be warranted to explore the mechanisms and risk factors for these adverse events.