Outcomes of pediatric endoscopic ultrasound-guided celiac plexus block: A single center pilot study

Area of Science:

• Pediatric Gastroenterology
• Interventional Endoscopy
• Pain Management

Background:

• Chronic pancreatitis and functional dyspepsia cause significant abdominal pain in children.
• Current treatment options for pediatric abdominal pain can be limited.
• Celiac plexus blocks (CPBs) are effective for adult chronic pancreatitis pain.

Purpose of the Study:

• To evaluate the efficacy and safety of endoscopic ultrasound-guided celiac plexus blocks (EUS-CPB) in pediatric patients.
• To assess pain relief, enteral tolerance, and activity improvements following EUS-CPB.
• To compare outcomes between pediatric chronic pancreatitis and functional dyspepsia cohorts.

Main Methods:

• Prospective study of pediatric patients undergoing EUS-CPB.
• Data collected at 2, 4, and 8 weeks post-procedure.
• Outcomes measured included pain scores, enteral tolerance, and school/activity attendance.

Main Results:

• Thirteen pediatric patients underwent 21 EUS-CPB procedures.
• In the chronic pancreatitis cohort, responders experienced a mean pain relief of 11.7 weeks.
• In the functional dyspepsia cohort, mean improvement in pain or enteral tolerance was 4.8 weeks.
• Acute recurrent/chronic pancreatitis patients showed more sustained relief than functional dyspepsia patients.

Conclusions:

• EUS-guided CPB is a viable option for managing abdominal pain in select pediatric patients.
• The study provides preliminary data on EUS-CPB utility in pediatric chronic pancreatitis and functional dyspepsia.
• EUS-CPB can be a component of multimodal pain management strategies in children.