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KMID : 0191120000150020173
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Journal of Korean Medical Science
2000 Volume.15 No. 2 p.173 ~ p.178
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CT-guided celiac plexus block for intractable abdominal pain
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Lee JM
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Abstract
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Treatment of intractable abdominal pain due to inoperable intraabdominal malignancy is
important, and the ineffectiveness of pharmacological agents has led many investigators
to recommend chemical neurolysis of the celiac ganglions as a treatment. The author
describes the technique and results of celiac plexus neurolysis under CT-guidance with
various approach routes, including anterior, posterior and transaortic routes. Twenty-eight
patients, ranging in age from 36 to 82 years, have been treated with this procedure. All
had inoperable or recurred intraabdominal malignancies and suffered from intractable upper
abdominal pain and/or back pain. The author performed the procedure using absolute alcohol
by an anterior approach (n=18), posterior approach (n=6) and transaortic approach (n=4).
Pain was rated according to a visual analog scale before and after the procedure to gauge
treatment success. No major complications occurred. Mild hypotension occurred in five
patients (18%) and transient diarrhea in six patients (21%). Twenty-one (75%) of the 28
patients had some relief of pain and 17 of these patients (61%) had good relief of pain
after the procedure. The results support that CT-guided celiac plexus block with alcohol
is a safe and effective means of pain control in patients with intraabdominal malignancy.
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