What Is A Celiac Plexus Block?

The celiac plexus is a bundle of nerves located in your upper abdomen, behind the stomach near the celiac artery and the abdominal aorta. It connects nerves from the liver, pancreas, gallbladder, stomach, spleen, and kidneys to your brain and spinal cord. When pain occurs in one of these organs, often due to a tumor or other damage, a celiac plexus block can help relieve that pain. A celiac plexus block is an injection that delivers pain medication as well as a medication that destroys or damages the nerves for longer-lasting pain relief. The procedure is a low-risk, non-surgical treatment that, if successful the first time, will most likely continue to provide pain relief with repeated treatments

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Why Is A Celiac Plexus Block Performed?

Celiac plexus blocks are a minimally invasive treatment option that can relieve severe pain for many people, allowing many to resume their normal daily activities. Celiac plexus blocks are commonly used to relieve upper abdominal pain, including pain related to:

  • Metastatic cancer in the abdomen
  • Chronic pancreatitis
  • Liver tumors
  • Cancer pain that is intractable and has been unresponsive to most pain treatments. For patients with pain that is unresponsive to other treatments, or who suffer from serious side effects from cancer treatments, celiac plexus blocks reduce pain and can increase your overall quality of life.

The amount and duration of pain relief varies from person to person and can be temporary, with some experiencing pain relief for weeks and others for years.

How Is A Celiac Plexus Block Performed?

For the procedure itself, you lie flat on your belly on an examination table. Your doctor will apply a topical anesthetic to numb the area. Sometimes your doctor may recommend intravenous sedation to make the procedure more comfortable. Using X-ray guidance, your doctor inserts a thin needle next to your spine. When the tip is in the correct position, a second needle is placed on the opposite side of the vertebrae. Contrast dye and local anesthetic are injected. If the needle and the block are properly administered, you will experience nearly instantaneous and profound pain relief. Your doctor may also inject another medication that destroys the celiac nerves for longer-lasting pain relief. The entire procedure usually takes less than 30 minutes. Your physician will monitor your pain and vital signs (pulse, blood pressure, temperature) after the procedure. For many patients experiencing severe abdominal pain, Celiac plexus blocks are an appropriate non-surgical, low risk treatment. As with any procedure, there can be side effects. Most of these are due to misplacement of the needle and could include the following:

  • Bleeding
  • Infection
  • Collapsed lung (pneumothorax)
  • Puncture of surrounding organs
  • Puncture of adjacent vessels
  • Drug allergy
  • Nerve damage
  • Paralysis

Using X-ray guidance can help prevent many of these side effects. The most common side effects related to the procedure itself are hypotension and transient diarrhea.

What Should I Expect After Having A Celiac Plexus Block?

Celiac plexus recovery is usually easy and marked by profound pain relief. After your procedure, you may experience a warm feeling spreading in your abdomen, which is due to the dispersion of the medication across the celiac plexus. Take it easy for 24 hours following the procedure. Have someone drive you home from your appointment and rest for the remainder of the day. Avoid heavy lifting or strenuous physical activity. You can eat and drink as normal immediately following the celiac plexus block procedure.  You may experience some mile numbness in your legs due to the anesthetic, and your belly may feel weak or numb. Normal feeling should return to these areas once the anesthetic from the procedure wears off.