2024 Volume 31 Issue 4 Pages 69-72
We report a case of intractable pain due to erosion in the edge of an ileostomy improved by thoracic root block. The patient was a 60-year-old woman who had a burning pain due to erosion in an edge of the ileostomy. She was on hemodialysis and had a history of morphine dependence. She used diclofenac suppositories and developed a gastric ulcer. Her previous physician started continuous epidural block and referred her to our hospital for pain control. After removal of the epidural catheter, we performed right Th10 root block with a pulsed radiofrequency. Her pain was alleviated, and the numerical rating scale (NRS) was reduced to 4/10. An ileostomy can cause severe pain because the surrounding skin is easily damaged by the strong alkaline intestinal fluid. This pain is initially nociceptive, but after a long period of time, it may become intractable due to central sensitization. Treatment for neuropathic pain, including nerve blocks, may be useful for this intractable pain.
