A new approach to the neurolytic block of the coeliac plexus: The transaortic technique

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Abstract
The celiac plexus block techniques pointing out the complications involved and stressing the seriousness of the neurological complications due to spread of the neurolytic agent to the sympathetic chain and the lumbar plexus. Contrast enhanced CT [computed tomography] scans demonstrate the difficulties involved in confining the neurolytic agent to the anterior, peri-aortic and precrural regions. A recent experience with celiac plexus block by means of a single transaortic needle in 28 patients was reported. In 12 of the patients, the CT scan revealed a spread of the neurolytic agent anterior and lateral to the aorta; on all occasions this spread was anterior to the medial crura of the diaphragm, sometimes extending laterally towards the costovertebral gutter along the ventral surface of the diaphragm. [Visceral] pain relief was obtained in 93% of the cases and no complications were observed. The transaortic technique is simple and a control lateral scan provides a characteristic image.