Turkish Journal of Physical Medicine and Rehabilitation

Rare complication of ganglion impar blockade with the transsacrococcygeal approach: A case of rectal perforation

Mehmet Okçu 1 ,Savaş Şencan 1 ,Osman Hakan Gündüz 1
1 Department of Physical Medicine and Rehabilitation, Division of Pain Medicine, Marmara University Faculty of Medicine, Istanbul, Türkiye DOI : 10.5606/tftrd.2022.8874 Although it has been reported that caution should be exercised in terms of rectal perforation, as the ganglion impar is located just behind the rectum in the presacral space, the authors could not find any case or images of rectal perforation occurring during ganglion impar blockade in the literature. In this report, the case of a 38-year-old female with rectal perforation that developed during ganglion impar blockade, performed by the transsacrococcygeal approach under fluoroscopy guidance, is presented. Wrong needle selection and the structurally short presacral space of the patient may have influenced the development of rectal perforation in the patient. This study presents the first case and images of rectal perforation in the literature that developed during the application of ganglion impar blockade using the transsacrococcygeal technique. In ganglion impar block applications, technically appropriate needles should be used, and care should be taken in terms of rectal perforation. Keywords : Coccygodynia, ganglion impar blockade, rectal perforation, rectum perforation, transsacrococcygeal approach