Two cases of cone-beam CT-assisted fluoroscopy-guided splanchnic nerve neurolysis for managing non-cancer pain

Abstract

A 46-year-old male suffered from upper and left abdominal pain caused by alcohol induced pancreatitis. As oral analgesics were not effective and caused drowsiness resulting in difficulties in his job, splanchnic nerve neurolysis (SNN) with ethanol was performed. Pain relief was immediately achieved and he returned to his job. He was free from pain 50 months after the procedure. A 57-year-old male suffered from intermittent pain of upper abdomen and back caused by recurrent cholangitis. He was unable to continue his job due to intolerable pain despite taking oral analgesics. After performing SNN, pain was immediately relieved. He returned to his job and had little pain which could be managed with a single use of acetaminophen 36 months after the procedure. CT-assisted fluoroscopy-guided SNN is an effective procedure and could be a good option for non-cancer upper abdominal pain. However, neurolysis induces permanent destruction of the plexus by ethanol, which should be taken into considered before performing this procedure.