Percutaneous retrocrural versus ultrasound-guided coeliac plexus neurolysis for refractory pancreatic cancer pain

2020 ◽  
pp. bmjspcare-2020-002246
Author(s):  
Yasushi Motoyama ◽  
Hitoaki Sato ◽  
Yuki Nomura ◽  
Norihiko Obata ◽  
Satoshi Mizobuchi
Keyword(s):  
Pancreatic Cancer ◽  
Abdominal Pain ◽  
Cancer Pain ◽  
Contrast Medium ◽  
Endoscopic Ultrasound ◽  
Ultrasound Guided ◽  
Coeliac Artery ◽  
Successful Case ◽  
Upper Abdominal ◽  
End Stage

We report a successful case of fluoroscopic percutaneous retrocrural coeliac plexus neurolysis (PRCPN) for pancreatic cancer pain refractory to endoscopic ultrasound-guided coeliac plexus neurolysis (EUS-CPN). A 55-year-old man with upper abdominal pain due to end-stage pancreatic cancer underwent EUS-CPN. Although CT revealed distribution of the contrast medium with neurolytic agent around the left and cephalic sides of the coeliac artery, the pain did not improve and became even more severe. PRCPN was performed, resulting in the drastic improvement of pain immediately. PRCPN should be considered when EUS-CPN is not effective.

scholarly journals Infected Pancreatic Necrosis Mimicking Pancreatic Cancer

2020 ◽  
Vol 14 (2) ◽  
pp. 436-442
Author(s):  
Jun Heo
Keyword(s):  
Pancreatic Cancer ◽  
Abdominal Pain ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Pancreatic Necrosis ◽  
Necrotizing Pancreatitis ◽  
Needle Aspiration ◽  
Infected Pancreatic Necrosis ◽  
Ultrasound Guided ◽  
Fine Needle

Although infected pancreatic necrosis can develop as a result of rare conditions involving trauma, surgery, and systemic infection with an uncommon pathogen, it usually occurs as a complication of pancreatitis. Early phase of acute pancreatitis can be either edematous interstitial pancreatitis or necrotizing pancreatitis. The late complications of pancreatitis can be divided into pancreatic pseudocyst due to edematous interstitial pancreatitis or walled-off necrosis due to necrotizing pancreatitis. During any time course of pancreatitis, bacteremia can provoke infection inside or outside the pancreas. The patients with infected pancreatic necrosis may have fever, chills, and abdominal pain as inflammatory symptoms. These specific clinical presentations can differentiate infected pancreatic necrosis from other pancreatic diseases. Herein, I report an atypical case of infected pancreatic necrosis in which abdominal pain, elevation of white blood cell, and fever were not found at the time of admission. Rather, a 10-kg weight loss (from 81 to 71 kg) over 2 months nearly led to a misdiagnosis of pancreatic cancer. The patient was finally diagnosed based on endoscopic ultrasound-guided fine-needle aspiration. This case highlights that awareness of the natural course of pancreatitis and infected pancreatic necrosis is important. In addition, endoscopic ultrasound-guided fine-needle aspiration should be recommended for the diagnosis and treatment of indeterminate pancreatic lesions in selected patients.

scholarly journals Predictors of pain response in patients undergoing endoscopic ultrasound-guided neurolysis for abdominal pain caused by pancreatic cancer

2016 ◽  
Vol 9 (4) ◽  
pp. 483-494 ◽  
Author(s):  
Kosuke Minaga ◽  
Masayuki Kitano ◽  
Hiroki Sakamoto ◽  
Takeshi Miyata ◽  
Hajime Imai ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Abdominal Pain ◽  
Endoscopic Ultrasound ◽  
Pain Response ◽  
Ultrasound Guided

Current Concept of Endoscopic Ultrasound-Guided Fine Needle Aspiration for Pancreatic Cancer

Pancreatology ◽  
2011 ◽  
Vol 11 (2) ◽  
pp. 40-46 ◽  
Author(s):  
Nobumasa Mizuno ◽  
Kazuo Hara ◽  
Susumu Hijioka ◽  
Vikram Bhatia ◽  
Yasuhiro Shimizu ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Current Concept ◽  
Ultrasound Guided ◽  
Fine Needle
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