Celiac Plexus Block in St. Louis

The celiac plexus is a dense bundle of nerves sitting in front of the aorta in the upper abdomen. Pain signals from the pancreas, liver, gallbladder, stomach and much of the intestine pass through it before traveling to the spinal cord. When those organs are the source of severe, persistent pain, interrupting the plexus reduces the signal reaching the brain. It is a mainstay of treatment for chronic pancreatitis pain.

The patient lies face down and the skin and deeper tissues are numbed. Under fluoroscopic guidance, needles are advanced alongside the vertebral body until the tip sits at the plexus, and contrast confirms correct spread before medication is given. A diagnostic block uses local anesthetic; when that produces good relief, a neurolytic block using alcohol or phenol can extend the duration substantially.

The two clearest indications are pain from chronic pancreatitis and pain from upper abdominal cancers, particularly pancreatic cancer. In both settings the goal is not only comfort but reduced reliance on opioid medication, which carries its own burden of side effects in patients who are often already unwell.

Blood pressure is monitored during and after the procedure, since interrupting these sympathetic nerves can lower it temporarily. Increased bowel activity is common and expected. Most patients go home the same day. The celiac plexus is one of several sympathetic targets we treat, alongside the lumbar sympathetic chain and stellate ganglion.