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.

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.