S1747 Iatrogenic Cushing’s From Celiac Plexus Blocks for Chronic Pancreatitis

Tagliaferri, Ariana R; Abuarqob, Sewar; Cavanagh, Yana

doi:10.14309/01.ajg.0000859628.16000.79

Cited by 2 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Paresthesia is the most severe but very rare adverse effect, accounting for less than 1% of all complications [1,5]. To date, no case reports have documented adverse effects from steroid injections during CPB [2].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Chronic abdominal pain can be a burden for patients with underlying malignancies and/or benign diseases [1,2]. Various pain management strategies are implemented to improve the quality of life but are limited by their efficacy and side effects [1,2]. Nociceptive pain is a type of pain caused by injury to either superficial tissue, muscle, or bone, also known as somatic pain.…”

Section: Introductionmentioning

confidence: 99%

“…Celiac interventions are performed based on anatomical landmarks, but now modern practices include percutaneous, endoscopic, surgical, or computerized tomography (CT)-guided interventions [4]. Through the use of a multi-modal approach incorporating CPB, opiate dependence decreases and overall mortality and baseline functioning improves [1,2,4,5].…”

Section: Introductionmentioning

confidence: 99%

“…Conversely, those with pancreatitis had lower rates of complete initial remission and shorter durations until symptom recurrence [3]. Many studies have shown adequate pain control with CPB in chronic pancreatitis; however, more randomized controlled trials are warranted to compare techniques and overall outcomes [2,4].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Iatrogenic Cushing’s From Celiac Plexus Blocks for Chronic Pancreatitis: A Case Report

Tagliaferri¹,

Abuarqob²,

Cavanagh³

2023

Cureus

Self Cite

View full text Add to dashboard Cite

Chronic pancreatitis and pancreatic malignancies can result in chronic pain that is difficult to treat with traditional regimens. Various pain management strategies have been implemented to improve the quality of life for patients with these conditions, but these strategies are limited by their efficacy and side effects, including opiate dependence. Celiac plexus blocks (CPB) and celiac plexus neurolysis (CPN) were implemented to decrease opiate dependency and treat chronic pain for pancreatitis and pancreatic malignancy. Numerous approaches are used to facilitate CPB/CPN, including percutaneous, surgical, and endoscopic, guided as computerized tomography (CT), fluoroscopy, ultrasound (US), or endoscopic ultrasound (EUS) techniques. EUS is the latest development in CPB/CPN and the least commonly utilized method; however, it is highly efficacious and associated with minimal complications and/or risks. With endoscopic CPB/CPN, overall mortality improves. Despite the various complications associated with other techniques, no case report or current literature has documented the development of iatrogenic Cushing's disease from the use of steroids during CPB via any approach. Herein, we report the first case of iatrogenic Cushing's disease from CPB in the treatment of chronic pancreatitis. Future studies are warranted to examine the agents used in the chemical destruction for CPB/CPN, to avoid complications such as this.

show abstract

Section: Discussionmentioning

confidence: 99%