癌症诊断标志着一条艰难道路的开始,充满了与疾病相关的痛苦的深刻斗争。癌症相关的疼痛,这是复杂和情感上的痛苦,在治疗方面提出了独特的挑战。腹部癌症和转移经常导致严重且难以控制的疼痛,其对传统药物反应不佳。在这种情况下,神经松解术和内脏神经和腹腔神经丛的射频消融等干预措施已成为有效的策略,提供增强的疼痛缓解和减少对麻醉止痛药的需要。在这个案例报告中,我们描述了一例38岁男性患者,他有长期慢性胰腺炎病史,在十二指肠球壶腹附近有息肉样生长.患者接受了止痛药以减轻疼痛,但是严重的胃痛,呕吐,发烧持续。影像学检查支持诊断并显示慢性胰腺炎,持续的炎症过程,和壶腹周围腺癌.患者处于诊断块的俯卧位置时疼痛明显,因此,在射频消融之前进行了竖脊肌平面阻滞。患者在接受诊断性内脏神经阻滞后接受了T11和T12级别的射频消融,显著减少疼痛。在两次随访中强调了这些介入程序在提高患者生活质量和减少对麻醉药品依赖方面的有效性,四,六个月几乎没有不适。此实例强调了将神经溶解和射频消融视为治疗慢性胰腺炎和腹部癌症引起的严重腹痛的重要替代方法的重要性。
A cancer diagnosis marks the beginning of a difficult path filled with a profound battle against the excruciating pain associated with the illness. Cancer-related pain, which is complex and emotionally distressing, presents unique challenges in terms of treatment. Abdominal cancers and metastases frequently result in severe and unmanageable pain that does not respond well to traditional medications. In such situations, interventions like neurolysis and radiofrequency ablation of the splanchnic nerves and celiac plexus have emerged as effective strategies, providing enhanced pain relief and reducing the need for narcotic painkillers. In this
case report, we describe a
case of a 38-year-old man with a longstanding history of chronic pancreatitis with a polypoid growth close to the ampulla in the duodenal bulb. The patient was given pain medications to alleviate the pain, but the severe stomach pain, vomiting, and fever persisted. Imaging tests supported the diagnosis and showed chronic pancreatitis, a continuing inflammatory process, and a periampullary adenocarcinoma. The patient had significant pain while being positioned prone for the diagnostic block, hence an erector spinae plane block was done before the radiofrequency ablation. The patient received radiofrequency ablation at the T11 and T12 levels after receiving a diagnostic splanchnic nerve block, significantly reducing pain. The effectiveness of these interventional procedures in enhancing the patient\'s quality of life and decreasing their dependence on narcotic drugs was highlighted by follow-up visits at two, four, and six months that revealed little to no discomfort. This instance emphasizes the importance of considering neurolysis and radiofrequency ablation as essential alternatives for treating severe abdominal pain brought on by chronic pancreatitis and abdominal cancer.