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Paraplegia following coeliac plexus block

Franco De Conno1, Augusto Caraceni, Luca Aldrighetti

  • 1Pain Therapy and Palliative Care Division National Cancer Institute, MilanItaly Departments of Clinical Surgery, University of Milan, Scientific Institute, San Raffaele Hospital, MilanItaly Departments of Clinical Neurology IV, University of Milan, Scientific Institute, San Raffaele Hospital, MilanItaly.

Pain
|December 1, 1993
PubMed
Summary

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Coeliac plexus block (CPB) can cause paraplegia due to spinal cord ischemia. This rare complication highlights the need for careful patient selection and alternative pain management strategies for advanced pancreatic cancer.

Area of Science:

  • Neurology
  • Pain Management
  • Oncology

Background:

  • Coeliac plexus block (CPB) is a neurolytic procedure for chronic cancer pain.
  • Pancreatic cancer often presents with severe, intractable pain.

Observation:

  • A rare case of paraplegia following CPB with ethyl alcohol is reported.
  • Clinical and neurophysiological findings suggested acute myelopathy due to ischemia of Adamkievicz's artery.

Findings:

  • CPB, while effective for cancer pain, carries a risk of severe neurological complications.
  • Ischemia of Adamkievicz's artery is a potential cause of myelopathy after CPB.

Implications:

  • This case underscores the importance of a multidisciplinary approach to managing pancreatic cancer pain.

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  • Alternative and complementary pain management strategies should be considered for patients undergoing CPB.