Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) is a well-established intervention to palliate malignant pain. We report a patient who developed hepatic and splenic infarction and bowel ischemia following EUS-CPN. A 69-year-old man with known lung cancer and pancreatic metastasis was transferred for debilitating, significant epigastric pain for several months. The patient underwent EUS-CPN to palliate the pain. After the procedure, the patient complained continuously of abdominal pain, nausea, and vomiting; hematemesis and hematochezia were newly developed. Abdominal computed tomography revealed infarction of the liver and spleen and ischemia of the stomach and proximal small bowel. On esophagogastroduodenoscopy, hemorrhagic gastroduodenitis, and multiple gastric ulcers were noted without active bleeding. The patient expired on postoperative day 27 despite the best supportive care.

Citations

Citations to this article as recorded by  

• Endoscopic Management of Pain due to Chronic Pancreatitis
  Arjun Kundra, Daniel S. Strand, Vanessa M. Shami
  Gastrointestinal Endoscopy Clinics of North America.2024; 34(3): 433.     CrossRef
• Endoscopic Ultrasound-Guided Celiac Plexus Block Can Be a Useful Procedure for Pain Relief in Chronic Pancreatitis When Used Selectively
  Nikhil Sonthalia, Vikram Patil, Awanish Tewari, Akash Roy, Mahesh Kumar Goenka
  Journal of Digestive Endoscopy.2023; 14(04): 203.     CrossRef
• Endoscopic ultrasound-guided celiac plexus neurolysis for managing abdominal pain related with advanced cancer
  Ryota Nakano, Hideyuki Shiomi, Shogo Ota, Hiroko Iijima
  International Journal of Gastrointestinal Intervention.2022; 11(3): 126.     CrossRef
• Computed Tomography-Guided Celiac Plexus Block in the Setting of Pancreatic Cancer: Case Study and Review
  David Weinstein, Sophie Gonzalez, David Sacks
  Journal of Radiology Nursing.2022; 41(3): 159.     CrossRef
• Endoscopic Ultrasound-Guided Celiac Plexus Interventions
  Pedro Moutinho-Ribeiro, Pedro Costa-Moreira, Ana Caldeira, Sílvia Leite, Susana Marques, Teresa Moreira, Nuno Nunes, Miguel Bispo
  GE - Portuguese Journal of Gastroenterology.2021; 28(1): 32.     CrossRef
• Endoscopic ultrasonography-guided celiac plexus neurolysis in patients with unresectable pancreatic cancer: An update
  Guillermo Pérez-Aguado, Diego Martinez-Acitores de la Mata, Carlos Marra-López Valenciano, Ignacio Fernandez-Urien Sainz
  World Journal of Gastrointestinal Endoscopy.2021; 13(10): 460.     CrossRef
• Efficacy of EUS-guided celiac plexus neurolysis compared with medication alone for unresectable pancreatic cancer in the oxycodone/fentanyl era: a prospective randomized control study
  Yoshihide Kanno, Shinsuke Koshita, Kaori Masu, Takahisa Ogawa, Hiroaki Kusunose, Toji Murabayashi, Toshitaka Sakai, Fumisato Kozakai, Kei Ito
  Gastrointestinal Endoscopy.2020; 92(1): 120.     CrossRef
• Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis
  Kosuke Minaga, Mamoru Takenaka, Ken Kamata, Tomoe Yoshikawa, Atsushi Nakai, Shunsuke Omoto, Takeshi Miyata, Kentaro Yamao, Hajime Imai, Hiroki Sakamoto, Masayuki Kitano, Masatoshi Kudo
  Cancers.2018; 10(2): 50.     CrossRef
• Consensus guidelines on the optimal management in interventional EUS procedures: results from the Asian EUS group RAND/UCLA expert panel
  Anthony Y B Teoh, Vinay Dhir, Mitsuhiro Kida, Ichiro Yasuda, Zhen Dong Jin, Dong Wan Seo, Majid Almadi, Tiing Leong Ang, Kazuo Hara, Ida Hilmi, Takao Itoi, Sundeep Lakhtakia, Koji Matsuda, Nonthalee Pausawasdi, Rajesh Puri, Raymond S Tang, Hsiu-Po Wang, A
  Gut.2018; 67(7): 1209.     CrossRef
• Celiac Plexus Block and Neurolysis
  Amit H. Sachdev, Frank G. Gress
  Gastrointestinal Endoscopy Clinics of North America.2018; 28(4): 579.     CrossRef
• Eus-guided therapy for pancreatic pain: easy, effective and safe. why isn´t the first therapeutic approach?
  Pilar Castro Carbajo, Lydia Elena Pradera Andrés, Carolina Navarro, Luis Ramón Rábago Torres
  Gastroenterology & Hepatology: Open Access.2018;[Epub]     CrossRef
• Endoscopic ultrasound‐guided celiac plexus block and neurolysis
  Ichiro Yasuda, Hsiu‐Po Wang
  Digestive Endoscopy.2017; 29(4): 455.     CrossRef
• Endoscopic Palliation of Pancreatic Cancer
  Vishal B. Gohil, Jason B. Klapman
  Current Treatment Options in Gastroenterology.2017; 15(3): 333.     CrossRef
• EUS-guided celiac plexus neurolysis
  Ichiro YASUDA, Shinpei DOI, Masatoshi MABUCHI
  Suizo.2015; 30(2): 191.     CrossRef
• Therapeutic role of endoscopic ultrasound in pancreaticobiliary disease: A comprehensive review
  Fan-Sheng Meng
  World Journal of Gastroenterology.2015; 21(46): 12996.     CrossRef

Citations

Citations to this article as recorded by  

• Imaging Surveillance of High Risk-Patients for Early Detection of Pancreatic Cancer
  Mostafa Alnoury, Hashim R. Mehdi, Atif Zaheer
  Seminars in Roentgenology.2024;[Epub]     CrossRef
• Present status of ultrasound elastography for the diagnosis of pancreatic tumors: review of the literature
  Takamichi KUWAHARA, Kazuo HARA, Nobumasa MIZUNO, Shin HABA, Nozomi OKUNO
  Choonpa Igaku.2022; 49(3): 275.     CrossRef
• Recent Advances in Endosonography—Elastography: Literature Review
  Akira Yamamiya, Atsushi Irisawa, Koki Hoshi, Akane Yamabe, Naoya Izawa, Kazunori Nagashima, Takahito Minaguchi, Masamichi Yamaura, Yoshitsugu Yoshida, Ken Kashima, Yasuhito Kunogi, Fumi Sakuma, Keiichi Tominaga, Makoto Iijima, Kenichi Goda
  Journal of Clinical Medicine.2021; 10(16): 3739.     CrossRef
• Pancreatic cancer in 2021: What you need to know to win
  Valeria Tonini, Manuel Zanni
  World Journal of Gastroenterology.2021; 27(35): 5851.     CrossRef
• Endoscopic ultrasonography elastography in the diagnosis of intrapancreatic ectopic spleen: A case report
  Nan Ge, Si-Yu Sun
  World Journal of Clinical Cases.2020; 8(9): 1729.     CrossRef
• Present status of ultrasound elastography for the diagnosis of pancreatic tumors: review of the literature
  Takamichi Kuwahara, Kazuo Hara, Nobumasa Mizuno, Shin Haba, Nozomi Okuno
  Journal of Medical Ultrasonics.2020; 47(3): 413.     CrossRef
• Impact of endoscopic ultrasonography on diagnosis of pancreatic cancer
  Masayuki Kitano, Takeichi Yoshida, Masahiro Itonaga, Takashi Tamura, Keiichi Hatamaru, Yasunobu Yamashita
  Journal of Gastroenterology.2019; 54(1): 19.     CrossRef
• Early Detection of Pancreatic Cancer: Opportunities and Challenges
  Aatur D. Singhi, Eugene J. Koay, Suresh T. Chari, Anirban Maitra
  Gastroenterology.2019; 156(7): 2024.     CrossRef
• Diagnostic Efficacy of Endoscopic Ultrasound Elastography in Differentiating Solid Pancreatic Lesions: A Single-Center Experience
  Ahmed Youssef Altonbary, Hazem Hakim, Ahmed Mohamed El-Shamy
  Clinical Endoscopy.2019; 52(4): 360.     CrossRef
• Elastography of the Pancreas, Current View
  Christoph F. Dietrich, Michael Hocke
  Clinical Endoscopy.2019; 52(6): 533.     CrossRef
• Endoscopic ultrasound elastography in the diagnosis of pancreatic masses: A meta-analysis
  Binglan Zhang, Fuping Zhu, Pan Li, Shishi Yu, Yajing Zhao, Minmin Li
  Pancreatology.2018; 18(7): 833.     CrossRef
• Endoscopic ultrasound (EUS) elastography and strain ratio, could it help in differentiating malignant from benign pancreatic lesions?
  Hussein Hassan Okasha, Reem Ezzat Mahdy, Shaimaa Elkholy, Mohamed Sayed Hassan, Ahmed Nabil El-Mazny, Kareem Essam Eldin Hadad, Moustafa Saeed, Mohamed El-Nady, Osama Soliman Elbalky, Asem Ashraf, Amr Abo El-Magd, Abeer Awad
  Medicine.2018; 97(36): e11689.     CrossRef
• Differentiation of Pancreatic Masses via Endoscopic Ultrasound Strain Ratio Elastography Using Adjacent Pancreatic Tissue as the Reference
  Nadan Rustemović, Mirjana Kalauz, Katja Grubelić Ravić, Hrvoje Iveković, Branko Bilić, Zvonimir Ostojić, Dalibor Opačić, Iva Ledinsky, Matea Majerović, Ana Višnjić
  Pancreas.2017; 46(3): 347.     CrossRef
• Endoscopic ultrasound elastography for solid pancreatic lesions
  Tanyaporn Chantarojanasiri, Pradermchai Kongkam
  World Journal of Gastrointestinal Endoscopy.2017; 9(10): 506.     CrossRef
• New Imaging Techniques
  Julio Iglesias-García, Jose Lariño-Noia, Juan Enrique Domínguez-Muñoz
  Gastrointestinal Endoscopy Clinics of North America.2017; 27(4): 551.     CrossRef
• Maximizing the endosonography: The role of contrast harmonics, elastography and confocal endomicroscopy
  Andrada Seicean, Ofelia Mosteanu, Radu Seicean
  World Journal of Gastroenterology.2017; 23(1): 25.     CrossRef
• Prospective cohort study comparing transient EUS guided elastography to EUS-FNA for the diagnosis of solid pancreatic mass lesions
  J. Mayerle, G. Beyer, P. Simon, E.J. Dickson, R.C. Carter, F. Duthie, M.M. Lerch, C.J. McKay
  Pancreatology.2016; 16(1): 110.     CrossRef
• Elasticity of the tibial nerve assessed by sonoelastography was reduced before the development of neuropathy and further deterioration associated with the severity of neuropathy in patients with type 2 diabetes
  Fukashi Ishibashi, Miki Taniguchi, Rie Kojima, Asami Kawasaki, Aiko Kosaka, Harumi Uetake
  Journal of Diabetes Investigation.2016; 7(3): 404.     CrossRef
• Endoscopic Ultrasound Elastography for Pancreatic Cancer Diagnosis: A Step Forward?
  Woo Jin Lee
  Clinical Endoscopy.2013; 46(2): 116.     CrossRef