Unusual or unexpected effect of treatment, Unexpected drug reaction , Clinical situation which can not be reproduced for ethical reasons, Rare co-existance of disease or pathology
Kaja Richard, Garrett Waggoner, Matthew Donnan, Kwabena Ayesu, Mario Madruga, Steve J. Carlan
Department of Medicine, Orlando Regional Healthcare, Orlando, FL, USA
Am J Case Rep 2020; 21:e921241
Available online: 2020-01-24
Degenerative disc disease of the lumbar spine can be associated with spinal canal and neuroforaminal stenosis, resulting in severe pain. Conservative approaches to treatment are generally recommended initially, especially in the elderly. Epidural corticosteroid injections can provide significant but temporary pain relief and are a commonly performed procedure in pain management. Pancreatitis caused by corticosteroids is unusual and the prognosis typically is good.
CASE REPORT: A 73-year-old woman presented with severe intractable back pain 1 week after lumbar epidural steroid injection for symptomatic spinal stenosis. Imaging confirmed severe multi-level degenerative disc disease of the lumbar spine resulting in severe canal and bilateral neuroforaminal stenosis. Because of abdominal pain and nausea, an abdominal CT and labs were performed, revealing evidence of pancreatic inflammation.
CONCLUSIONS: Lumbar epidural steroid injection may be a risk factor for developing steroid-induced pancreatitis.
Keywords: Epidural Space, Glucocorticoids, Pancreatitis