Celiac plexus block: an anatomical study and simulation using computed tomography

• Published in: Radiologia brasileira Vol. 47; no. 5; pp. 283 - 287
• Main Authors: Pereira, Gabriela Augusta Mateus, Lopes, Paulo Tadeu Campos, Dos Santos, Ana Maria Pujol Vieira, Pozzobon, Adriane, Duarte, Rodrigo Dias, Cima, Alexandre da Silveira, Massignan, Ângela
• Format: Journal Article
• Language: English
• Published: Brazil Colégio Brasileiro de Radiologia e Diagnóstico por Imagem 01-10-2014
• Subjects: Original; RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING; Computed tomography; Anatomy; Transcrural pathway; Celiac plexus block; Anatomia; Tomografia computadorizada; Acesso transcrural; Bloqueio do plexo celíaco
• ISSN: 0100-3984; 1678-7099; 0100-3984; 1678-7099
• DOI: 10.1590/0100-3984.2013.1881

To analyze anatomical variations associated with celiac plexus complex by means of computed tomography simulation, assessing the risk for organ injury as the transcrural technique is utilized.
One hundred eight transaxial computed tomography images of abdomen were analyzed. The aortic-vertebral, celiac trunk (CeT)-vertebral, CeT-aortic and celiac-aortic-vertebral topographical relationships were recorded. Two needle insertion pathways were drawn on each of the images, at right and left, 9 cm and 4.5 cm away from the midline. Transfixed vital organs and gender-related associations were recorded.
Aortic-vertebral - 45.37% at left and 54.62% in the middle; CeT-vertebral - T12, 36.11%; T12-L1, 32.4%; L1, 27.77%; T11-T12, 2.77%; CeT-aortic - 53.7% at left and 46.3% in the middle; celiac-aortic-vertebral - L-l, 22.22%; M-m, 23.15%; L-m, 31.48%; M-l, 23.15%. Neither correspondence on the right side nor significant gender-related associations were observed.
Considering the wide range of abdominal anatomical variations and the characteristics of needle insertion pathways, celiac plexus block should not be standardized. Imaging should be performed prior to the procedure in order to reduce the risks for injuries or for negative outcomes to patients. Gender-related anatomical variations involved in celiac plexus block should be more deeply investigated, since few studies have addressed the subject.