Celiac Plexus Block

What is the celiac plexus?

The celiac plexus is a bundle of nerves found in the upper part of the belly. It sits behind the pancreas. The celiac plexus connects nerves of the pancreas, intestines, gall bladder, liver, and stomach to the brain and spinal cord. Nerves send messages from the brain and spinal cord to other parts of the body. 

What is a celiac plexus block?

A celiac plexus block is a type of nerve block or neural blockade. The procedure damages the nerves of the celiac plexus. This damage, also called neurolysis, stops or lessens pain messages from the brain to the celiac plexus. These messages are caused by something irritating or pressing on the celiac plexus. This pain is not well managed with medication. A celiac plexus block is used to manage this type of pain. Tumors, mostly of the pancreas, can press on the celiac plexus causing pain. 

How is it done?

The procedure can be done in a few ways. It can be done during surgery or by placing a needle through the skin using an endoscopic ultrasound (EUS) or CT (Cat Scan) to guide the needle. The surgical area or where the needle is being placed is cleaned. The area and the nerves are numbed. Once the provider gets to the celiac plexus, the nerves are damaged by injecting them with a neurolytic agent (substance). The procedure takes about 30-60 minutes. 

What are the benefits?

• You may have less pain. Most people do not have total relief of their pain. The nerve block lasts 3-6 months and may need to be repeated.
• You may need less pain medication.
• You may have a better quality of life

What are the risks?

• Low blood pressure. You should make sure to drink plenty of liquids before the procedure. 
• The block doesn’t work.
• Diarrhea.
• Pain or muscle spasm at injection site.

Some less common risks are the neurolytic agent is injected into the bloodstream instead of the nerves, injury to other nerves, or damage to nearby organs from the needle. 

When should you call your provider?

If you are having bleeding, fever, signs of infection (redness, swelling, warmth, drainage) at the injection or surgical site, or your pain is not relieved, you should call your provider. Talk to your provider about your concerns, risks, and benefits of a celiac plexus block.