Severe diarrhea following neurolytic coeliac plexus block: case report and literature review.

Abstract

Diarrhea is one of the commonest complication following coeliac plexus ablative procedures. It is believed to occur due to inadvertent chemical sympathectomy by the block. For the majority of patients, complications are temporary and self limited. Unfortunately few cases of refractory diarrhea have been reported and some of them proved fatal. The mainstay of therapy is aggressive hydration to restore body fluids and early treatment with antidiarrheal agents. This includes the use of high fiber diet, opioids, anticholinergics, alpha 2 agonists and somatostatin analogues e.g., Octreotide in an attempt to inhibit gut motility and control the diarrhea. We would like to present a case of severe diarrhea following a neurolytic coeliac plexus block using alcohol 50% in a patient with cancer pancreas. Patient achieved a significant reduction in her pain scores but developed severe diarrhea and dehydration. Diarrhea was refractory to medical treatment and patient died few weeks later.