PT  - JOURNAL ARTICLE
AU  - Tantillo, Simona
AU  - Sbaraini Zernini, Irene
AU  - Benvenuti, Francesco
AU  - Guarnera, Martina
AU  - Talarico, Francesco
AU  - Giuntoli, Lorenzo
AU  - Cilloni, Nicola
TI  - #36316 Tap-block as a diagnostic and monitoring tool in acute surgical abdomen: a case report
AID  - 10.1136/rapm-2023-ESRA.583
DP  - 2023 Sep 01
TA  - Regional Anesthesia & Pain Medicine
PG  - A306--A307
VI  - 48
IP  - Suppl 1
4099  - http://rapm.bmj.com/content/48/Suppl_1/A306.2.short
4100  - http://rapm.bmj.com/content/48/Suppl_1/A306.2.full
SO  - Reg Anesth Pain Med2023 Sep 01; 48
AB  - Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page) Application for ESRA Abstract Prizes: I don’t wish to apply for the ESRA PrizesBackground and Aims The transversus abdominis plane (TAP) block is a regional technique for anterolateral abdominal wall analgesia. It is widely used for postsurgical acute pain management, in the context of a multimodal opioid-sparing analgesia. The cornerstone of major abdominal surgery pain management is continuous epidural analgesia. However, especially in the ICU environment, the insertion of an epidural catheter, in addition to being affected by the coagulative arrangement, could be contraindicated by antiaggregation or anticoagulation therapy. It also required advanced technical skills. Moreover, TAP block presented fewer contraindication and it is a rather simple procedure with a shallow learning curve ant it provides long-lasting analgesia.Abstract #36316 Figure 1 Pelvic CT scanAbstract #36316 Figure 2 Abdomen CT scanMethods Patient, 67 years-old, admitted to ICU for post-surgical management after a duodenocephalopancreatectomy for cholangiocarcinoma. In 12th day he developed an acute abdominal pain, prevalent in the upper quadrants, radiating to the back, with a progressive anemization. The clinical pain manifestation, described by patient, seemed suggestive for acute post-surgical pancreatitis. We decided to make a TAP block for pain relief and to discriminate between visceral or somatic pain. Within few minutes, the patient was free of pain. So, in the suspicion of hemorrhagic complication, as the pain trigger, we performed a FAST-US which revealed free fluid around liver and in the Douglas cavity. The patient was subjected to a CT confirming the US finding and he underwent an abdominal surgical procedure.Conclusions We described a case report in which TAP block was successfully used in the differential diagnosis of an acute abdomen in critical care setting.