title: [Celiac block in paediatric patients using endoscopic ultrasound for management of severe pain due to chronic pancreatitis. Review of the technique in 2 cases].
abstract: BACKGROUND
  Pancreatic diseases such as cancer, idiopathic recurrent pancreatitis, and chronic pancreatitis, can cause pain that is difficult to control. Pain is one of the most debilitating symptoms and demands increasing doses of analgesics and narcotics, as well as the number of hospital admissions, with a direct implication in the costs of medical treatments.
  
  
  OBJECTIVE
  To describe the experience with 2 paediatric patients who were subjected to an ultrasound-guided endoscopic celiac ganglion block for difficult pain management, secondary to chronic pancreatitis disease.
  
  
  METHODS
  The first case concerns a 9-year-old male with a diagnosis of chronic pancreatitis, and the second case is a 12-year-old female who developed episodes of intermittent acute pancreatitis. Both cases suffered from chronic abdominal pain, which was difficult to control with stronger painkillers, such as opioids. The pain decreased after patients were subjected to an ultrasound-guided endoscopic celiac ganglion block.
  
  
  CONCLUSIONS
  This technique showed that both patients obtained satisfactory pain relief, with significant improvements in general symptomatology and the stopping of almost all analgesic medication. The authors suggest that celiac ganglion block must be considered, and implemented early before the usual complications, such as a consumption syndrome that is frequent in paediatric patients with chronic pancreatitis.
authors.affiliation: Servicio de Endoscopias y Ultrasonido Endoscópico, Hospital de Especialidades Dr. Manuel Bernardo Sepúlveda, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México. Electronic address: membriale@hotmail.com.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Membrillo-Romero
authors.affiliation: Servicio de Anestesiología y Medicina del Dolor, Hospital de Especialidades Dr. Manuel Bernardo Sepúlveda, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
authors.forename: Dulce María
authors.initials: DM
authors.lastname: Rascón-Martínez
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000628:therapy*; D002447:Celiac Plexus; D002648:Child; D002760:Cholangiopancreatography, Endoscopic Retrograde; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009407:Nerve Block / Q000379:methods*; D059408:Pain Management / Q000379:methods*; D010192:Pancreatic Pseudocyst / Q000150:complications; D050500:Pancreatitis, Chronic / Q000150:complications*; D016717:Sphincterotomy, Endoscopic; D018084:Ultrasonography, Interventional / Q000379:methods*
keywords: Bloqueo celiaco; Celiac block; Endoscopic ultrasound; Paediatrics; Pediátricos; Ultrasonido endoscópico