The celiac plexus is a bundle of nerves in your upper abdomen. These nerves provide sensations, including pain, to your upper abdomen. This includes organs such as your liver, pancreas, gallbladder and stomach.

A celiac plexus block is the injection of a medication for pain control in the upper abdomen. The injection is usually done to help manage pain for people who have chronic pancreatitis or pancreatic cancer.

You will have this procedure in the Northwestern Medicine Anesthesiology/Pain Medicine Clinic.

What to Expect During a Celiac Plexus Block

During the procedure:

• You will lie face down on a procedure table.
• Your care team will clean your back.
• They will place a drape over your back to keep the area sterile.
• Your physician will use a small needle to numb the skin at each injection site.
• Using an X-ray for guidance, your physician will place needles on either side of your spine.
• They will inject contrast dye to be sure the placement is correct.
• They will inject a local anesthetic to numb the surrounding nerve fibers.

This procedure is called a diagnostic nerve block. It will determine if a nerve block can stop the pain that may be coming from this area. If it does stop the pain, a steroid medication may be injected for temporary treatment.

Celiac plexus blocks decrease pain in most patients with pancreatic-related pain. Side effects can include:

• Diarrhea (most common)
• Bleeding
• Infection
• Allergic reaction
• Nerve damage
• Hiccups
• A drop in blood pressure when standing

Neurolysis

If the celiac plexus block provides pain relief, you may be a good candidate for a procedure called neurolysis.

For neurolysis, your physician will use an alcohol to permanently block the affected nerve. This is usually used for patients with advanced disease whose pain cannot be managed in other ways.

The procedure for neurolysis is similar to the celiac plexus. However, you may be sedated so the procedure is more comfortable.