Alhazzani W, Al-Shamsi HO, Greenwald E, Radhi J, Tse F. Chronic abdominal pain secondary to mesenteric panniculitis treated successfully with endoscopic ultrasonography-guided celiac plexus block: A case report. World J Gastrointest Endosc 2015; 7(5): 563-566 [PMID: 25992196 DOI: 10.4253/wjge.v7.i5.563]
Corresponding Author of This Article
Waleed Alhazzani, MD, FRCPC, MSc, Departments of Clinical Epidemiology and Biostatistics, McMaster University, 50 Charlton Ave. E, Hamilton, Ontario L8S 4L8, Canada. alhazzaw@mcmaster.ca
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. May 16, 2015; 7(5): 563-566 Published online May 16, 2015. doi: 10.4253/wjge.v7.i5.563
Chronic abdominal pain secondary to mesenteric panniculitis treated successfully with endoscopic ultrasonography-guided celiac plexus block: A case report
Waleed Alhazzani, Humaid O Al-Shamsi, Eric Greenwald, Jasim Radhi, Frances Tse
Waleed Alhazzani, Humaid O Al-Shamsi, Eric Greenwald, Frances Tse, Department of Medicine, McMaster University, Hamilton, Ontario L8S 4L8, Canada
Waleed Alhazzani, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario L8S 4L8, Canada
Jasim Radhi, Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario L8S 4L8, Canada
Author contributions: Alhazzani W designed and drafted the report; Al-Shamsi HO drafted and edited the report; Radhi J performed the pathology review; Greenwald E and Tse F reviewed and edited the paper.
Informed consent: Patient consented to publish the case, consent attached.
Conflict-of-interest: None of the authors have any conflict of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Waleed Alhazzani, MD, FRCPC, MSc, Departments of Clinical Epidemiology and Biostatistics, McMaster University, 50 Charlton Ave. E, Hamilton, Ontario L8S 4L8, Canada. alhazzaw@mcmaster.ca
Telephone: +1-905-5212100 Fax: +1-905-5216068
Received: September 17, 2014 Peer-review started: September 20, 2014 First decision: September 28, 2014 Revised: October 21, 2014 Accepted: March 4, 2015 Article in press: March 5, 201 Published online: May 16, 2015
Abstract
Mesenteric panniculitis is a chronic illness that is characterized by fibrosing inflammation of the mesenteries that can lead to intractable abdominal pain. Pain control is a crucial component of the management plan. Most patients will improve with oral corticosteroids treatment, however, some patients will require a trial of other immunosuppressive agents, and a minority of patients will continue to have refractory disease. Endoscopic ultrasound guided celiac plexus block is used frequently to control abdominal pain in patients with pancreatic pathology. To our knowledge there are no case reports describing its use in mesenteric panniculitis patients with refractory abdominal pain.
Core tip: Mesenteric panniculitis is a rare disorder that can present with refractory and disabling abdominal pain, we describe a novel intervention using endoscopic ultrasonography guided celiac plexus block to control the refractory abdominal pain in a patient with mesenteric panniculitis. This approach is based on the anatomical supply of the epigastric area where the pain is originating.
