Richard Kaja, Waggoner Garrett, Donnan Matthew, Ayesu Kwabena, Madruga Mario, Carlan Steve J
Department of Medicine, Orlando Regional Healthcare, Orlando, FL, USA.
Division of Academic Affairs and Research, Orlando Regional Healthcare, Orlando, FL, USA.
Am J Case Rep. 2020 Feb 10;21:e921241. doi: 10.12659/AJCR.921241.
BACKGROUND Degenerative disc disease of the lumbar spine can be associated with spinal canal and neuroforaminal stenosis, resulting in severe pain. Conservative approaches to treatment are generally recommended initially, especially in the elderly. Epidural corticosteroid injections can provide significant but temporary pain relief and are a commonly performed procedure in pain management. Pancreatitis caused by corticosteroids is unusual and the prognosis typically is good. CASE REPORT A 73-year-old woman presented with severe intractable back pain 1 week after lumbar epidural steroid injection for symptomatic spinal stenosis. Imaging confirmed severe multi-level degenerative disc disease of the lumbar spine resulting in severe canal and bilateral neuroforaminal stenosis. Because of abdominal pain and nausea, an abdominal CT and labs were performed, revealing evidence of pancreatic inflammation. CONCLUSIONS Lumbar epidural steroid injection may be a risk factor for developing steroid-induced pancreatitis.
背景 腰椎间盘退变疾病可能与椎管及神经孔狭窄相关，导致严重疼痛。通常最初建议采用保守治疗方法，尤其是对于老年人。硬膜外皮质类固醇注射可提供显著但短暂的疼痛缓解，是疼痛管理中常用的操作。由皮质类固醇引起的胰腺炎并不常见，且预后通常良好。病例报告 一名73岁女性在因症状性椎管狭窄接受腰椎硬膜外类固醇注射1周后出现严重的顽固性背痛。影像学检查证实腰椎存在严重的多节段椎间盘退变疾病，导致严重的椎管及双侧神经孔狭窄。由于腹痛和恶心，进行了腹部CT检查和实验室检查，结果显示有胰腺炎症的迹象。结论 腰椎硬膜外类固醇注射可能是发生类固醇诱导性胰腺炎的一个危险因素。
