Flank hernia secondary to phenol nerve block.

Abstract

The management of patients with chronic pain is challenging. The aim of treatment is alleviation of symptoms in an attempt to increase functional capacity. Interventional procedures, such as chemical neurolysis are adopted when other techniques fail to provide adequate pain control.

An 82-year-old man presented with a history of chronic left sided abdominal pain. This was initially treated with central nerve blockade. His symptoms persisted and he was scheduled for an intercostal neurolytic block with 6% aqueous phenol. Following the procedure, he experienced further abdominal pain and developed a painful left flank swelling. CT scan, ultrasound scan, and colonoscopy excluded the presence of an organic cause, such as intra-abdominal pathology. A left flank hernia was subsequently diagnosed. Conservative management was employed. Surgical repair will be implemented should conservative measures fail to control symptoms.

This case raises our awareness of a complication that may occur with phenol intercostal neurolysis.