Celiac Plexus Block
What is the celiac plexus?
The celiac plexus is a group or web of nerves found in the upper part of your abdomen (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 procedure done to place a nerve block or neural blockade on the celiac plexus. During this procedure, the nerves of the celiac plexus are damaged on purpose. This damage, also called neurolysis, stops or lessens pain messages from the celiac plexus to the brain and spinal cord. These pain messages are caused by something rubbing or pressing on the celiac plexus. This pain is hard to manage 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 scan to guide the needle.. 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 medication. 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. Be sure to drink plenty of liquids before the procedure. Take your time going from lying or sitting to standing.
- The block doesn’t work.
- Pain or muscle spasm at injection site.
Very rarely, there can be more serious risks. The neurolytic medication may be injected into the bloodstream instead of the nerves, there can be injury to other nerves or damage to nearby organs from the needle. Talk with your provider about the risks of this procedure.
What can I expect after the procedure?
After the procedure, you will be monitored for at least a few hours. You may receive IV (intravenous) fluids. Your blood pressure may be low after the procedure, so your care team will monitor your vital signs as well. You may have diarrhea after the procedure, which often goes away within 48 hours. If diarrhea does not get better, call your provider. You may have back pain or weakness in your leg from the numbing medicine used. Ask your provider about any side effects you may have.
When should I call my provider?
You should call your provider if you have:
- Fever (100.4°F or 38.0°C) or other signs of infection (redness, swelling, warmth, drainage) at the injection or surgical site.
- Pain that does not get better with prescribed medications.
Talk to your provider about the benefits and risks of a celiac plexus block, as well as any concerns you may have.
D'Souza RS, Hooten WM. Neurolytic Blocks. [Updated 2023 Jan 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537360/
Gupta R, Madanat L, Jindal V, Gaikazian S. Celiac Plexus Block Complications: A Case Report and Review of the Literature. J Palliat Med. 2021 Sep;24(9):1409-1412. doi: 10.1089/jpm.2020.0530. Epub 2021 Jan 4. PMID: 33395560.
John, R.S., Dixon, B. & Shienbaum, R. 2021. Celiac Plexus Block. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK531469/
Pancreatic Cancer Action Network. Celiac Plexus Block. https://pancan.org/facing-pancreatic-cancer/living-with-pancreatic-cancer/managing-side-effects-palliative-care/symptoms-pain/celiac-plexus-block/
RadiologyInfo.org. 2020. Nerve Blocks. https://www.radiologyinfo.org/en/info/nerveblock