GASTROPARESIS AFTER CELIAC PLEXUS BLOCK

A 36-yr-old woman with metastatic mucinous cystadenocarcinoma of the p ancreas underwent neurolytic celiac plexus block with 100% ethanol and 0.5% bupivacaine for intractable back pain. Several hours after the p rocedure she developed severe nausea and vomiting, which persisted for days despite cessation of opioid analgesics, and administration of in travenous metoclopramide and ondansetron, Both esophagogastroduodenosc opy and barium examination of the stomach and small intestine showed e xcess gastric fluid but no evidence of mechanical obstruction. A radio nuclide study revealed delayed gastric emptying of solids. Treatment w ith oral cisapride 10 mg p.o. q.i.d. resulted in considerable symptoma tic improvement. We document the first reported case of gastroparesis after celiac plexus block and discuss possible etiological mechanisms. (C) 1998 by Am, Cell. of Gastroenterology.