内镜超声引导下腹腔神经丛松解术后脊髓缺血：病例报告及文献复习
Spinal cord ischemia after endoscopic ultrasound guided celiac plexus neurolysis: case report and review of the literature.
作者信息
Köker Ibrahim Hakkı, Aralaşmak Ayşe, Ünver Nurcan, Asil Talip, Şentürk Hakan
机构信息
a Medicine Faculty, Gastroenterology Department , Bezmialem Vakıf University , Istanbul , Turkey.
b Medicine Faculty, Radiology Department , Bezmialem Vakıf University , Istanbul , Turkey.
出版信息
Scand J Gastroenterol. 2017 Oct;52(10):1158-1161. doi: 10.1080/00365521.2017.1335771. Epub 2017 Jun 18.
INTRODUCTION
Endosonography guided celiac plexus neurolysis is efficacious in the management of severe pain due to advanced pancreatic cancer. Although endoscopic ultrasound (EUS) guided celiac neurolysis (CN) is mostly a safer procedure than the percutaneous posterior approach, severe complications such as paraplegia have been reported.
CASE REPORT
We describe a patient with advanced adenocarcinoma of the pancreas and severe pain who developed irreversible paraplegia after EUS guided CN.
CONCLUSIONS
Endosonography guided celiac plexus neurolysis also might be complicated with paraplegia as already observed with percutaneous approach. The underlying mechanism could not be explained clearly until now. We detected concomitant embolic occlusion of Adamkiewicz and anterior radicularis magna arteries in magnetic resonance angiography. So, this procedure must be considered only for malignancy patients.
引言
超声内镜引导下腹腔神经丛毁损术在治疗晚期胰腺癌所致的严重疼痛方面疗效显著。虽然内镜超声（EUS）引导下腹腔神经丛毁损术（CN）通常比经皮后路方法更安全，但仍有诸如截瘫等严重并发症的报道。
病例报告
我们描述了一名患有晚期胰腺腺癌且疼痛严重的患者，其在EUS引导下CN术后发生了不可逆的截瘫。
结论
超声内镜引导下腹腔神经丛毁损术也可能并发截瘫，这在经皮方法中已被观察到。直到现在，其潜在机制仍无法明确解释。我们在磁共振血管造影中检测到Adamkiewicz动脉和胸段大前根动脉同时发生栓塞性闭塞。因此，该手术必须仅考虑用于恶性肿瘤患者。
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