STELLATE GANGLION BLOCK ALLEVIATES PSEUDOOBSTRUCTION SYMPTOMS FOLLOWED BY EPISODES OF HYPERMETROPIA - CASE-REPORT

Background and Objectives. The chronic intestinal pseudo-obstruction d ue to visceral myopathy is a disorder resembling bowel obstruction but without mechanical occlusion. Frequently, parenteral nutrition become s the final palliative treatment. A patient affected with this syndrom e for 16 years was suffering causalgic pain provoked by intraveneous p erfusion. Stellate ganglion block was requested in the hope of maintai ning the perfusion. Methods. Stellate ganglion block not only stopped the pain but unexpectedly, it temporarily relieved the pseudo-obstruct ion symptoms. Two radiofrequency coagulations in the stellate ganglion prolonged the beneficial effects on gastrointestinal transit for more than 3 weeks, after which the symptoms returned. Multidisciplinary an d multicenter advice was that further destructive treatments not be at tempted. Results. Repetitive stellate ganglion blocks with 2 mL of bup ivacaine 0.75% restored gastrointestinal function for more than 3 week s. However, after performance of radiofrequency coagulation, infiltrat ion with bupivacaine was followed by hypermetropia on the right eye of 2 weeks duration. Conclusions. The relationship between stellate gang lion block and gastrointestinal function has not been described. This case report does not provide sufficient information to recommend this technique for pseudo-obstruction symptoms. Moreover, the result in thi s case is a fortuitous observation, lacking a clear scientific explana tion. Further study may be warranted.