Acute abdominal pain is a common emergency consultation, with a 10-30% risk of chronification. When medical options fail, interventional techniques are required. A 35-year-old woman presented with sudden abdominal pain in the right hypochondrium, radiating to the back (VAS 9-10). She exhibited anemia without hemodynamic instability. An angioCT revealed a 15 cm subcapsular hepatic hematoma associated with adenomas, causing right hemidiaphragm elevation and pleural effusion. Prophylactic embolization was performed, and the patient was admitted for multidisciplinary management. Due to poor pain control and refractoriness to medical treatment, a right splanchnic nerve block guided by CT and pulsed radiofrequency was performed, achieving significant improvement, opioid reduction, and initiation of physical therapy. The splanchnic nerves innervate the abdominal viscera. Their blockade is an effective alternative for chronic abdominal pain, preventing prolonged opioid use and its adverse effects. This case highlights the early utility of interventional techniques.
