To relieve intractable upper abdominal cancer pain using 75% alcohol, Celiac Plexus Blocks (C.P.B.) were performed by means of the classic two needle technique in 7 cases and by single needle transaortic method in 3 cases under fluroscopic guidance. Both methods relieved the pain effectively and there was no significant hemorragic, neurologic and other complications. The degree of pain relief estimated by Graphic Rating Scale (GRS) and the incidence of complication were similar between two methods but the single needle transaortic method was more simple, easier and effective with just one third of alcohol used in the classic method.
Celiac Plexus* ; Incidence ; Needles

Alcoholic celiac plexus blocks have been used to relieve intractable upper abdominal cancer pain. Various techniques have been proposed including the use of the X-ray and CT scanner to improve results and to avoid complications. We used the CT scanner and the X-ray fluroscope for 36 cases of alcoholic celiac plexus blocks to determine the depth and position of the needle without previous diagnostic blocks. Good to excellent pain relief occurred in more than 72% of the patients and the advantages of the use of the CT scanner showed that 1) placement of the needle tip is easily established according to the surrounding anatomical structures. 2) the operator can introduce the needle without anxiety. 3) the time required for block are saved.
Alcoholics ; Anxiety ; Celiac Plexus* ; Humans ; Needles

No abstract available.
Abdominal Pain* ; Celiac Plexus* ; Gastroparesis* ; Humans

No abstract available.
Abdominal Pain* ; Celiac Plexus* ; Gastroparesis* ; Humans

Since the introduction of endoscopic ultrasound (EUS) in the 1990s, it has evolved from a primarily diagnostic modality into an instrument that can be used in various therapeutic interventions. EUS-guided fine-needle injection was initially described for celiac plexus neurolysis. By using the fundamentals of this method, drainage techniques emerged for the biliary and pancreatic ducts, fluid collections, and abscesses. More recently, EUS has been used for ablative techniques and injection therapies for patients with for gastrointestinal malignancies. As the search for minimally invasive techniques continued, EUS-guided hemostasis methods have also been described. The technical advances in EUS-guided therapies may appear to be limitless; however, in many instances, these procedures have been described only in small case series. More data are required to determine the efficacy and safety of these techniques, and new accessories will be needed to facilitate their implementation into practice.
Abscess ; Celiac Plexus ; Drainage* ; Endosonography ; Hemostasis* ; Humans ; Pancreatic Ducts ; Ultrasonography

Neurolysis of the celiac plexus has been performed to relieve intractable pain cauaed by carcinoma of the pancreas, liver, gall bladder or atomach. It is also occasionally effective in controlling the pain of chronic pancreatitis. In practice, hoarever celiac plexus 71oct ig not a simple procedure to the beginner. The results and 77mplications are variable, In order to correctly inject neurolytic agents into or near the celiac plexus and to reduce the time consumed to perform celiac plexus block, we used CT scanner for 7 cases of alcohol celiac plexus b1ock. The effects will be described. The purpose Of 7hia article is to improve the technical aspect of Celiac Plexus block to the beginner.
Celiac Plexus* ; Liver ; Pain, Intractable ; Pancreas ; Pancreatitis, Chronic ; Urinary Bladder

Intractable pain from nonresectable or recurrent cancer of upper abdominal organs has been treated in many ways. We chose the method of 50% alcohol celiac plexus block for the pain relief. The results were as follows: 1) It is relatively simple, highly effective, and a less hazardous means of palliative therapy. 2) Satisfactory pain relief was seen in 11 cases (91.7%), excluding 1 case (8.3%) with no improvement in hospitalization state. We concluded this block is remarkably safe as well as effective and should be employed more frequently.
Celiac Plexus* ; Hospitalization ; Methods ; Pain, Intractable ; Palliative Care

A neurolytic celiac plexus block produces long-lasting pain relief in upper abdominal cancer patients. Unwanted side effects such as local pain, hypotension, and diarrhea are common but the durations of these side effects are usually transient. Chronic diarrhea induced by a neurolytic celiac plexus block is rarely reported and is considered to be an autonomic neuropathy due to sympathetic denervation. A 73-year-old Klatskin tumor patient developed chronic diarrhea after a neurolytic celiac plexus block and the diarrhea was sustained for 3 months despite the use of conventional antidiarrheal treatments. We report a case of chronic diarrhea that was induced by a neurolytic celiac plexus block.
Aged ; Celiac Plexus* ; Diarrhea* ; Humans ; Hypotension ; Klatskin's Tumor ; Sympathectomy

Celiac plexus neurolysis is performed to relieve intractable upper abdominal pain. Since Kappis had performed splanchnic nerve block in 1919, many methods and its modifications of celiac plexus block have been introduced. In 1983, Ischia and in 1990, Lieberman has introduced the transaortic technique of celiac plexus block. We employed a transaortic approach with some modification of the original method in 12 patients, in which a single needle was advanced from a left posterior paramedian approach through the aorta to deposit the drug directly onto the celiac plexus. After needle has punctured anterior wall of aorta, 50% alcohol 20ml was injected and after retracting the needle to the posterior wall of aorta, also 50% alcohol 20ml was injected. 11 patients experienced marked pain relief and no major complication was encountered. The authors think that our method has some theoretical benefits in effectiveness than the original transaortic method.
Abdominal Pain ; Aorta ; Celiac Plexus* ; Humans ; Needles* ; Splanchnic Nerves

A 61-year-old man who had cholangiocarcinoma with multiple metastasises was referred to our hospital for his pain control.Celiac plexus block with 99.9% alcohol was performed by the retrocrural approach under fluoroscopic guidance.Examination of the patient at fifteen minutes after successfully performing the diagnostic block showed no sensory or motor change.Forty-eight hours after the neurolysis, the patient's lower extremities were totally paralyzed, and he could not walk nor control his anal sphincter.But thereafter he progressively recovered.Five days after celiac plexus neurolysis, he was able to walk with support from one hand.Reversible ischemia of the spinal cord due to damage to the Adamkiewicz arterial blood supply was thought to be the cause.
Celiac Plexus ; Cholangiocarcinoma ; Humans ; Ischemia ; Lower Extremity ; Middle Aged ; Neoplasm Metastasis ; Paraplegia ; Spinal Cord