gms | German Medical Science

Objective: The authors investigated the possibility of improving refractory abdominal visceral pain with a retroperitoneal catheter implantation and continuous drug delivery around the celiac ganglion in a patient with multiple abdominal operations including a liver part resection, abdominal adhesion and multiple abdominal wall hernia operations.

Method: In a 36-year-old female patient the refractory abdominal visceral pain syndrome resulted in reduced quality of life (QoL) and an untreatable pain that failed multimodal pain therapy. The 10 point Visual analog scale (VAS) before treatment was 8. Computertomography (CT) navigated blockade of the celiac ganglion with Carbostesin and Volon A was conducted multiple times interdisciplinary. After sufficient short-term pain relief a CT controlled catheter implantation retroperitoneal to the celiac ganglion and connection to an implanted subcutaneous port system for continuous drug delivery were performed.

Results: Significant pain relief was achieved. A VAS Score improvement from 8 to 0 was seen directly postoperatively. Three month after surgical treatment the VAS score was 2. After 6 month postoperatively a VAS score reduction to 0 was achieved. An improvement of the Quality of Life (QoL) and the daily activity level were further achieved and accompanied by a sustained reduction in demand for analgesics. There were no postoperative complications.

Conclusions: CT navigated catheter implantation retroperitoneal the celiac ganglion for continuous drug delivery seems to be an effective and safe alternative option to relieve refractory abdominal visceral pain if conservative treatment modalities fail.