ANTERIOR ULTRASOUND-GUIDED SUPERIOR HYPOGASTRIC PLEXUS BLOCK IN ABDOMINAL AND PELVIC PAIN IN CROHN`S DISEASE: A CASE REPORT

I.N. Akhmetov1,2, Rim.A. Gilfanova1,2, Rid.A. Gilfanova1,2, R.A. Zefirov1,3, S.I. Spiridonov1

1Republican Clinical Hospital, Kazan

2Kazan State Medical Academy ― Branch Campus of the FSBEI FPE RMACPE MOH Russia, Kazan

3Kazan (Volga Region) Federal University, Kazan

Akhmetov Irek N. ― Head of the Department of X-ray Surgical Methods of Diagnosis and Treatment №2 of the Republican Clinical Hospital

138 Orenburgsky Trakt, building A, Kazan, 420064, Russian Federation, tel. +7-917-873-79-43, e-mail: irek456@yandex.ru

 Abstract. Crohn’s disease is a chronic, recurrent disease of the gastrointestinal tract (GIT) of unclear etiology, characterized by transmural, segmental, granulomatous inflammation with the development of local and systemic complications [1, 3].

The etiology of Crohn’s disease has not been established: the disease develops as a result of a combination of many factors, including genetic predisposition, defects in congenital and acquired immunity, intestinal microflora, and various environmental factors. Crohn’s disease can affect any part of the gastrointestinal tract, so the effective management of patients with Crohn’s disease is complex and requires multidisciplinary collaboration [1, 4].

The incidence and prevalence of Crohn’s disease are increasing worldwide, with an annual increase in incidence ranging from 4 to 15% over the past three decades [9]. At least half of patients with Crohn’s disease undergo one or more surgeries during their lifetime, often suffer from malnutrition and associated psychological disorders, and many of the operated patients are forced to live with a stoma [7]. The pain syndrome accompanying patients with Crohn’s disease during the long period of life remains the actual problem in modern realities and demands actualization of approaches.

A clinical observation demonstrates the use of upper subcostal plexus blockade by anterior access, under ultrasound control, in the treatment of chronic abdominal pain in Crohn’s disease as an alternative to the existing methods of analgesia.

Key words: Crohn’s disease, superior hypogastric plexus block, abdominal pain, pelvic pain.