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Cancer Pain – Celiac Plexus Block

Indications: Treatment of visceral abdominal pain (T5-T12) derived from sympathetic afferent nerves, often associated with abdominal cancers, especially pancreatic cancer. Occasionally to treat chronic pancreatitis.

How To Perform: Celiac plexus located at L1 on the anterolateral surface of the Aorta. Using fluoroscopy, typically performed with posterior entry point just below the level of the 12th rib.

Side Effects: Orthostatic Hypotension (most common), Diarrhea (2nd most common), Spinal/Epidural Injection, LAST, Perforation of Nearby Structures (Aortic/IVC/Visceral Organs), Retroperitoneal Hemorrhage, Pneumothorax, Chylothorax, Paraplegia

References

  1. Cornman-Homonoff J, Holzwanger DJ, Lee KS, Madoff DC, Li D. Celiac Plexus Block and Neurolysis in the Management of Chronic Upper Abdominal Pain. Semin Intervent Radiol. 2017 Dec;34(4):376-386 PubMed Link