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Gastroparesis after celiac plexus block

S Iftikhar1, E V Loftus

  • 1Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.

The American Journal of Gastroenterology
|November 20, 1998
PubMed
Summary
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A patient developed gastroparesis after a celiac plexus block for pancreatic cancer pain. Cisapride treatment improved symptoms, suggesting a potential treatment for this rare complication.

Area of Science:

  • Gastroenterology
  • Pain Management
  • Interventional Radiology

Background:

  • Neurolytic celiac plexus block is used for intractable abdominal pain, particularly in pancreatic cancer.
  • Complications of this procedure are rare but can be severe.
  • Gastroparesis, a condition of delayed gastric emptying, can significantly impact patient quality of life.

Observation:

  • A 36-year-old woman with metastatic pancreatic cancer developed severe, persistent nausea and vomiting post-celiac plexus block.
  • Diagnostic evaluations including esophagogastroduodenoscopy, barium studies, and radionuclide imaging revealed delayed gastric emptying without mechanical obstruction.
  • Symptoms were refractory to standard antiemetic and opioid-cessation therapies.

Findings:

  • The patient's symptoms were attributed to gastroparesis, a previously unreported complication of celiac plexus block.

Related Experiment Videos

  • Treatment with oral cisapride led to significant symptomatic improvement.
  • This suggests a potential iatrogenic cause for gastroparesis following this interventional procedure.

    • Implications:

    • This case highlights a rare but serious complication of celiac plexus block, necessitating increased awareness among clinicians.
    • Delayed gastric emptying should be considered in patients presenting with persistent nausea and vomiting post-procedure.
    • Further research into the etiological mechanisms and management strategies for post-celiac plexus block gastroparesis is warranted.