| CT-guided Celiac Plexus Neurolysis: A Review of Anatomy, Indications, Technique, and Tips for Successful Treatment. | |
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MedLine Citation:
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PMID: 21997984 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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The celiac plexus is the largest visceral plexus and is located deep in the retroperitoneum, over the anterolateral surface of the aorta and around the origin of the celiac trunk. It serves as a relay center for nociceptive impulses that originate from the upper abdominal viscera, from the stomach to the proximal transverse colon. Celiac plexus neurolysis, with agents such as ethanol, is an effective means of diminishing pain that arises from these structures. Percutaneous imaging-guided celiac plexus neurolysis has been established as an invaluable therapeutic option in the management of intractable abdominal pain in patients with upper abdominal malignancy. The use of multidetector computed tomography (CT) for imaging guidance has superseded other modalities and allows direct visualization of the spread of the neurolytic agent in the antecrural space. Accurate depiction of the retroperitoneal anatomy and the position of the needle tip helps avoid crucial anatomic structures such as the pancreas, aorta, celiac artery, and superior mesenteric artery. Proper patient education, meticulous preprocedure planning, use of optimal multidetector CT techniques, adjunctive CT maneuvers, and postprocedure care are integral to successful celiac plexus neurolysis. Celiac plexus neurolysis does not completely abolish pain; rather, it diminishes pain, helping to reduce opioid requirements and their related side effects and improving survival in patients with upper abdominal malignancy. © RSNA, 2011. |
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Authors:
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Avinash Kambadakone; Ashraf Thabet; Debra A Gervais; Peter R Mueller; Ronald S Arellano |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Radiographics : a review publication of the Radiological Society of North America, Inc Volume: 31 ISSN: 1527-1323 ISO Abbreviation: Radiographics Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-10-14 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8302501 Medline TA: Radiographics Country: United States |
Other Details:
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Languages: eng Pagination: 1599-621 Citation Subset: IM |
Affiliation:
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Division of Abdominal Imaging and Intervention, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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