Open AccessCoeliac plexus block in the management of chronic abdominal pain due to severe diabetic gastroparesis
Author(s) -
Dennis J. Wu,
Chadi Dib,
Bryan C. Hoelzer,
M. Molly McMahon,
Paul S. Mueller
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.06.2009.1986
Subject(s) - medicine , pregabalin , anesthesia , gabapentin , abdominal pain , celiac plexus , gastroparesis , metoclopramide , plexus , surgery , vomiting , gastric emptying , stomach , alternative medicine , pathology
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.