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Case report
Percutaneous retrocrural versus ultrasound-guided coeliac plexus neurolysis for refractory pancreatic cancer pain
  1. Yasushi Motoyama,
  2. Hitoaki Sato,
  3. Yuki Nomura,
  4. Norihiko Obata and
  5. Satoshi Mizobuchi
  1. Anesthesiology, Kobe University Graduate School of Medicine, Kobe, Japan
  1. Correspondence to Dr Yasushi Motoyama, Anesthesiology, Kobe University Graduate School of Medicine School of Medicine, Kobe 650-0017, Japan; paopaohaipao{at}yahoo.co.jp

Abstract

We report a successful case of fluoroscopic percutaneous retrocrural coeliac plexus neurolysis (PRCPN) for pancreatic cancer pain refractory to endoscopic ultrasound-guided coeliac plexus neurolysis (EUS-CPN). A 55-year-old man with upper abdominal pain due to end-stage pancreatic cancer underwent EUS-CPN. Although CT revealed distribution of the contrast medium with neurolytic agent around the left and cephalic sides of the coeliac artery, the pain did not improve and became even more severe. PRCPN was performed, resulting in the drastic improvement of pain immediately. PRCPN should be considered when EUS-CPN is not effective.

https://doi.org/10.1136/bmjspcare-2020-002246

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    Footnotes

    • Contributors YM wrote the initial draft of the manuscript. HS assisted in the preparation of the manuscript. YN, NO and SM reviewed the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.