Section of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital of Colorado, Digestive Health Institute, Children's Hospital Colorado, Aurora, Colorado, USA.
J Pediatr Gastroenterol Nutr. 2024 Nov;79(5):1056-1061. doi: 10.1002/jpn3.12348. Epub 2024 Aug 9.
Celiac plexus blocks (CPBs) using endoscopic ultrasound (EUS) guidance provide significant pain relief in adults with chronic pancreatitis. We present on EUS-guided CPB for pediatric patients with abdominal pain from chronic pancreatitis or severe functional dyspepsia necessitating clinically assisted nutrition and hydration. Patients who underwent EUS-CPB were included and followed prospectively at 2-, 4-, and 8-weeks postprocedure about pain, enteral tolerance, and school/activity attendance. Thirteen patients underwent EUS-guided CPB with a total of 21 procedures. In the pancreatitis cohort, mean pain relief was 11.7 weeks for those who responded. In the functional dyspepsia cohort, mean improvement (in either pain or enteral tolerance) was 4.8 weeks. Symptom improvement varied between the two cohorts. Acute recurrent/chronic pancreatitis patients demonstrated more sustained relief than the functional dyspepsia cohort. This study adds to the limited data investigating the utility of EUS-CPB as part of a multimodal treatment plan in pediatrics.
EUS 引导下腹腔神经丛阻滞（CPB）为慢性胰腺炎成人提供显著的疼痛缓解。我们报告了 EUS 引导下 CPB 在儿科患者中的应用，这些患者因慢性胰腺炎或严重功能性消化不良导致需要临床辅助营养和水合作用，并伴有腹痛。对接受 EUS-CPB 的患者进行前瞻性随访，在术后 2、4 和 8 周时评估疼痛、肠内耐受性和上学/活动参与情况。13 名患者接受了 EUS 引导下 CPB，共进行了 21 次操作。在胰腺炎组中，有反应者的平均疼痛缓解时间为 11.7 周。在功能性消化不良组中，平均改善（疼痛或肠内耐受性）为 4.8 周。两组患者的症状改善情况不同。急性复发性/慢性胰腺炎患者的缓解持续时间长于功能性消化不良组。本研究增加了有限的数据，这些数据调查了 EUS-CPB 在儿科多模式治疗计划中的应用。
