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Celiac Plexus Block in the Management of Chronic Abdominal Pain

  • Maunak V. Rana
  • Kenneth D. Candido
  • Omar Raja
  • Nebojsa Nick Knezevic
Anesthetic Techniques in Pain Management (D Wang, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Anesthetic Techniques in Pain Management

Abstract

Chronic abdominal pain is a devastating problem for patients and providers, due to the difficulty of effectively treating the entity. Both benign and malignant conditions can lead to chronic abdominal pain. Precision in diagnosis is required before effective treatment can be instituted. Celiac Plexus Block is an interventional technique utilized for diagnostic and therapeutic purposes in the treatment of abdominovisceral pain. The richly innervated plexus provides sensory input about pathologic processes in the liver, pancreas, spleen, omentum, alimentary tract to the mid-transverse colon, adrenal glands, and kidney. Chronic pancreatitis and chronic pain from pancreatic cancer have been treated with celiac plexus block to theoretically decrease the side effects of opioid medications and to enhance analgesia from medications. Historically, the block was performed by palpation and identification of bony and soft tissue anatomy; currently, various imaging modalities are at the disposal of the interventionalist for the treatment of pain. Fluoroscopy, computed tomography (CT) guidance and endoscopic ultrasound assistance may be utilized to aid the practitioner in performing the blockade of the celiac plexus. The choice of radiographic technology depends on the specialty of the interventionalist, with gastroenterologists favoring endoscopic ultrasound and interventional pain physicians and radiologists preferring CT guidance. A review is presented describing the indications, technical aspects, and agents utilized to block the celiac plexus in patients suffering from chronic abdominal pain.

Keywords

Chronic abdominal pain Celiac plexus block Chronic pancreatitis 

Notes

Compliance with Ethics Guidelines

Conflict of Interest

Dr. Maunak V. Rana, Dr. Kenneth D. Candido, Dr. Omar Raja, and Dr. Nebojsa Nick Knezevic each declare no potential conflicts of interest relevant to this article.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Disclaimers

None.

Financial Support

None.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Maunak V. Rana
    • 1
    • 2
  • Kenneth D. Candido
    • 1
    • 2
  • Omar Raja
    • 1
  • Nebojsa Nick Knezevic
    • 1
    • 2
  1. 1.Department of AnesthesiologyAdvocate Illinois Masonic Medical CenterChicagoUSA
  2. 2.Department of AnesthesiologyUniversity of IllinoisChicagoUSA

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