The Role of Celiac Plexus Block in Intractable Upper Abdominal Pain

1989 ◽  
pp. 161-169 ◽  
Author(s):  
Subhash Jain
Keyword(s):  
Abdominal Pain ◽  
Celiac Plexus ◽  
Celiac Plexus Block ◽  
Upper Abdominal ◽  
Plexus Block

scholarly journals Hemorrhagic Gastritis and Duodenitis Following Celiac Plexus Neurolysis

2009 ◽  
Vol 6;12 (6;12) ◽  
pp. 1001-1003
Author(s):  
Scott Pello
Keyword(s):  
Pancreatic Cancer ◽  
Abdominal Pain ◽  
Celiac Plexus ◽  
Celiac Plexus Block ◽  
Upper Endoscopy ◽  
Gi Bleeding ◽  
Upper Gi ◽  
History Of ◽  
Upper Abdominal ◽  
Plexus Block

Introduction: Neurolytic celiac plexus block is a well established intervention to palliate pain, and it potentially improves quality of life in patients suffering from an upper abdominal malignancy, specifically pancreatic cancer. Methods: We describe a 61-year-old female with a history of pancreatic cancer, unexplained transfusion dependent anemia with a normal recent upper endoscopy, and abdominal pain, who had previously undergone gastrojejunostomy and a Roux-en-Y hepaticojejunostomy as well as chemotherapy and radiation therapy. She suffered from intractable abdominal pain and elected to undergo palliative celiac plexus neurolysis. Results: The patient initially appeared to tolerate celiac plexus block well, however, 45 minutes after the procedure, the patient had bright red blood per rectum followed by bloody diarrhea. Her abdomen was soft and non-tender with minimal distention and positive bowel sounds. The patient’s hemoglobin decreased to 7.5 g/dl from 9.0 g/dl, and she received a blood transfusion. Upper endoscopy and enteroscopy demonstrated diffuse hemorrhagic gastritis and duodenitis. The bleeding was controlled and the patient remained hemodynamically stable. Ultimately, the patient did well and was discharged home. Discussion: We report a case of a patient with known history of gastritis and duodenitis, who developed severe upper GI bleeding immediately following the celiac plexus neurolysis. There are no published reports documenting similar cases. It is difficult to offer a precise physiologic explanation for this complication. However, we speculate that inhibition of sympathetic tone from the celiac plexus neurolysis caused increased blood flow to the GI system, and this resulted in active bleeding from previously indolent hemorrhagic gastritis and duodenitis. Conclusion: It may be beneficial for patients with a history of gastritis, duodenitis or GI bleeding to undergo a careful upper GI evaluation prior to celiac plexus neurolysis. Key words: Case report, pancreatic cancer, celiac plexus neurolysis, anemia, hemorrhagic gastritis and doudenitis, sympathetic block

scholarly journals Celiac Plexus Block and Neurolysis in the Management of Chronic Upper Abdominal Pain

2017 ◽  
Vol 34 (04) ◽  
pp. 376-386 ◽  
Author(s):  
Joshua Cornman-Homonoff ◽  
Daniel Holzwanger ◽  
Kyungmouk Lee ◽  
David Madoff ◽  
David Li
Keyword(s):  
Quality Of Life ◽  
Abdominal Pain ◽  
Side Effects ◽  
Celiac Trunk ◽  
Celiac Plexus ◽  
Opiate Dependence ◽  
Celiac Plexus Block ◽  
Upper Abdominal ◽  
Plexus Block

AbstractChronic upper abdominal pain occurs as a complication of various malignant and benign diseases including pancreatic cancer and chronic pancreatitis, and when present may contribute to lower quality of life and higher mortality. Though various pain management strategies are available as part of a multimodal approach, they are often incompletely effective and accompanied by side effects. Pain originating in upper abdominal viscera is transmitted through the celiac plexus, which is an autonomic plexus located in the retroperitoneum at the root of the celiac trunk. Direct intervention at the level of the plexus, referred to as celiac plexus block or neurolysis depending on the injectate, is a minimally invasive therapeutic strategy which has been demonstrated to decrease pain, improve function, and reduce opiate dependence. Various percutaneous techniques have been reported, but, with appropriate preprocedural planning, use of image guidance (usually computed tomography), and postprocedural care, the frequency and severity of complications is low and the success rate high regardless of approach. The main benefit of the intervention may be in reduced opiate dependence and opiate-associated side effects, which in turn improves quality of life. Celiac plexus block and neurolysis are safe and effective treatments for chronic upper abdominal pain and should be considered early in patients experiencing such symptoms.

The Role of Neurolytic Celiac Plexus Block in the Treatment of Pancreatic Cancer Pain

2008 ◽  
Vol 40 (4) ◽  
pp. 1200-1204 ◽  
Author(s):  
E. Polati ◽  
A. Luzzani ◽  
V. Schweiger ◽  
G. Finco ◽  
S. Ischia
Keyword(s):  
Pancreatic Cancer ◽  
Cancer Pain ◽  
Celiac Plexus ◽  
Celiac Plexus Block ◽  
Plexus Block

scholarly journals Celiac Plexus Neurolysis Using Three Different Techniques for Upper Abdominal Metastatic Pain: Comparison the Effectiveness of the Block

2014 ◽  
Vol 41 (2) ◽  
pp. 23-26
Author(s):  
MR Khandoker ◽  
ZR Khan ◽  
S Kawsar ◽  
MI Khademul ◽  
KAK Azad
Keyword(s):  
Initial Study ◽  
Celiac Plexus ◽  
Celiac Plexus Block ◽  
Skilled Manpower ◽  
Neurolytic Block ◽  
Upper Abdominal ◽  
Transaortic Approach ◽  
Plexus Block ◽  
Suitable Technique ◽  
Better Than

33 patients [13 female] with metastatic intractable upper Abdominal Cancer Pain were treated with celiac plexus neurolytic block with 60% alcohol. Aim of study is to observe the effectiveness of three different techniques of celiac plexus block, unilateral paravertibral, bilateral paravertibral and Paravertibral transaortic approach of celiac plexus blocks under C- arm guidance. Satisfactory pain relief occurs in all three techniques but out- come of transaortic approach a little better than other methods. Pain intensity was assessed by VRS and VAS Scale. Celiac plexus blocks are a suitable technique for upper abdominal visceral metastatic pain. Its effects are prolonged and also increase bowel movement, improve appetite and reduced morphine consumption. This is an initial study and numbers of subject are few. So more study required to get conclusive result. Skilled manpower and appropriate case selection is mandatory for successful results. DOI: http://dx.doi.org/10.3329/bmj.v41i2.18800 Bangladesh Medical Journal 2012 Vol. 41 No. 2: 23-26

scholarly journals Endoscopic Ultrasound-Guided Celiac Plexus Interventions

2020 ◽  
Vol 28 (1) ◽  
pp. 32-38
Author(s):  
Pedro Moutinho-Ribeiro ◽  
Pedro Costa-Moreira ◽  
Ana Caldeira ◽  
Sílvia Leite ◽  
Susana Marques ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Abdominal Pain ◽  
Chronic Pancreatitis ◽  
Endoscopic Ultrasound ◽  
Pancreatic Disease ◽  
Celiac Plexus ◽  
Celiac Plexus Block ◽  
Technical Issues ◽  
Control Pain ◽  
Plexus Block

Abdominal pain related to pancreatic disease is often extremely disabling. Endoscopic ultrasound (EUS)-guided celiac plexus block (CPB) is used to control pain associated with chronic pancreatitis. EUS-guided celiac plexus neurolysis (CPN) is typically used to reduce pain associated with pancreatic cancer and can be considered early at the time of diagnosis of inoperable disease. EUS-guided celiac plexus interventions have been shown to be significantly effective in pancreatic pain relief, which is achieved in approximately 70–80% of patients with pancreatic cancer and in 50–60% of those with chronic pancreatitis. Serious complications from CPB and CPN are rare. Most frequent adverse events are diarrhoea, orthostatic hypotension, and a transient increase in abdominal pain. In this article, the Portuguese Group for Ultrasound in Gastroenterology (GRUPUGE) presents an updated perspective of the potential role of EUS-guided celiac plexus interventions, addressing the selection criteria and technical issues of different techniques and analysing recent data on their safety and efficacy.

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