Coeliac plexus block in the management of chronic abdominal pain due to severe diabetic gastroparesis
- 1Mayo Clinic, Internal Medicine, 200 First Street SW, Rochester, MN 55902, Rochester, Minnesota 55902, USA
- 2Mayo Clinic, Anesthesiology, 200 First Street SW, Rochester, Minnesota 55902, USA
- 3Mayo Clinic, Division of Endocrinology, Diabetes, Metabolism, and Nutrition, 200 First Street SW, Rochester, Minnesota 55902, USA
- 4Mayo Clinic, General Internal Medicine, 200 First Street SW, Rochester, Minnesota 55902, USA
- Paul Mueller, muellerps{at}mayo.edu
- Published 26 November 2009
Summary
Abdominal pain can be disabling in patients with gastroparesis. The pathogenesis of pain in these individuals is poorly understood. Agents commonly used in clinical practice, including tricyclic antidepressants, gabapentin, and pregabalin, have remained largely unsatisfactory in treating this pain. We report the case of a 50-year-old woman presenting with chronic unrelenting abdominal pain due to severe diabetic gastroparesis that was managed successfully with coeliac plexus block with local anaesthesia and steroid injection. Adequate analgesia was achieved and maintained for 10 weeks following the coeliac plexus block, which allowed elimination of opiate requirements for pain management (and avoidance of narcotic associated constipation), continuation of percutaneous endoscopy jejunostomy tube feedings, and avoidance of long term parenteral nutrition.
Footnotes
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Competing interests: none.
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Patient consent: Patient/guardian consent was obtained for publication
