Jang Hee Yoon, Cha Sang-Woo, Lee Byung Hoo, Jung Ho Eun, Choo Jin Woo, Cho Yun-Ju, Ju Hye Young, Cho Young Deok
Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea.
Clin Endosc. 2013 May;46(3):306-9. doi: 10.5946/ce.2013.46.3.306. Epub 2013 May 31.
Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) is a well-established intervention to palliate malignant pain. We report a patient who developed hepatic and splenic infarction and bowel ischemia following EUS-CPN. A 69-year-old man with known lung cancer and pancreatic metastasis was transferred for debilitating, significant epigastric pain for several months. The patient underwent EUS-CPN to palliate the pain. After the procedure, the patient complained continuously of abdominal pain, nausea, and vomiting; hematemesis and hematochezia were newly developed. Abdominal computed tomography revealed infarction of the liver and spleen and ischemia of the stomach and proximal small bowel. On esophagogastroduodenoscopy, hemorrhagic gastroduodenitis, and multiple gastric ulcers were noted without active bleeding. The patient expired on postoperative day 27 despite the best supportive care.
内镜超声引导下腹腔神经丛毁损术（EUS-CPN）是一种成熟的缓解恶性疼痛的干预措施。我们报告了一例在EUS-CPN后发生肝脾梗死和肠缺血的患者。一名69岁男性，已知患有肺癌和胰腺转移，因数月来令人衰弱的严重上腹部疼痛而转诊。该患者接受了EUS-CPN以缓解疼痛。术后，患者持续抱怨腹痛、恶心和呕吐；新出现了呕血和便血。腹部计算机断层扫描显示肝脾梗死以及胃和近端小肠缺血。在食管胃十二指肠镜检查中，发现出血性胃十二指肠炎症和多处胃溃疡，但无活动性出血。尽管给予了最佳的支持治疗，患者仍在术后第27天死亡。
