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Paraplegia after celiac plexus neurolysis in a patient with pancreatic cancer - A case report and literature review -
Anesth Pain Med 2019;14(1):85-90
Published online January 31, 2019
© 2019 Korean Society of Neuroscience in Anesthesiology and Critical Care.

Sung Hoon Kim , Kyung Hwan Jang , Bo Kyung Cheon , Jeong Ae Lim , Nam Sik Woo , Hae Kyung Kim , and Jae-hun Kim
Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea
Correspondence to: Corresponding author Jae-hun Kim, M.D., Ph.D. Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea Tel: 82-2-2030-5470 Fax: 82-2-2030-5449 E-mail:
Received March 13, 2018; Revised July 18, 2018; Accepted August 3, 2018.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

A 65-year-old male patient underwent C-arm fluoroscopy-guided bilateral celiac plexus neurolysis to relieve peritoneal seeding-related pain associated with pancreatic cancer. Following confirmation of spreading, and no intravascular injection of contrast media, 7.5 ml of 0.25% chirocaine was injected in each side. The pain subsided after the block, with no motor or sensory deficits. Subsequently, celiac plexus neurolysis with 99.8% alcohol was performed using a posterolateral approach under fluoroscopic guidance. The patient was instructed to maintain a prone position for 2 hours while the procedure was performed. Approximately 4 hours later, the patient experienced paralysis of both lower extremities and hypoesthesia. Emergent magnetic resonance imaging of the thoracic and lumbar spine revealed gray matter signal change in the cord and conus medullaris at the T10–L1 level, and decreased perfusion at the T11–T12 vertebral bodies, suggesting spinal cord infarction. The patient remained paraplegic until his death 24 days later.

Key Words : Celiac plexus, Infarction, Pancreatic neoplasms, Paraplegia, Spinal cord

July 2019, 14 (3)
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